In August of 2016, Pennsylvania Psychiatric Institute (PPI), which is a unique collaboration of Penn State Medical Group and UPMC Pinnacle, decided it was time to address the historic Opioid Epidemic that was touching all parts of the United States and had quickly infiltrated Central Pennsylvania.
Under the direction of Dr. Sarah Kawasaki, PPI decided something needed to be done, and it needed to be done quickly. After hours of meetings, problem solving, and planning, PPI decided to plant Dr. Kawasaki, an internal medicine doctor with a specialty in addiction services, smack in the middle of a bustling primary care practice in downtown Harrisburg.
One of our major concerns was that patients, who had made the decision it was time to get help for their Opioid Use Disorder, would be directed to a phone tree where they might get lost in the shuffle, or get so frustrated they may change their minds about wanting and needing treatment. We knew that we had to strike when the iron was hot, and if we didn’t, a prospective patient may never make it through our doors.
We made a decision to bypass the usual “system,” which meant a few things. First, we jumped through a variety of security hoops and got our Program Manager, a LPC and CAADC, access and training to Penn State Medical Groups Electronic Medical Record, Registration, and Scheduling System. Second, we obtained a laptop and a secure cell phone. This would allow us to make this cell phone our official “office phone” where patients could contact a trained professional essentially 24 hours a day, 7 days a week to schedule an appointment to be assessed for life saving Medication Assisted Treatment, including Suboxone and Vivitrol. Many of our patients felt more comfortable texting, and this was possible on this phone – thus reducing another barrier. We have the ability to pop open our laptop and register and schedule patients during any time of day, any day of the week. We started our program in February 2017, and by the end of the first month, we had 20 patients. By the end of September 2017, we saw about 160 patients in our offices. When a patient calls, we do our best to see the patient as soon as possible. If a patient is discharging from a higher level of care, we like that patient to be seen in our offices the day they are discharged from that higher level of care.
We truly believe that removing the barriers of the phone tree and traditional office hours has allowed us to treat dozens of individuals that would have potentially given up hope if lost in a phone tree or if speaking with an individual who did not understand the disease of addiction. Our hope is that other programs will follow suite, and leave traditional “rules” and practices behind in an effort to make a dent in what is potentially the most severe public health crisis in decades. Dr. Kawasaki likes to say that a patient who reports Heroin use is no different than a patient reporting of chest pains. We need to start treating this population with the intensity and immediacy we afford other life threatening medical conditions, and something as simple as a cell phone and laptop is proving to make that possible.