Clinical Workflow and Substance Use Screening, Brief Intervention, and Referral to Treatment Data in the Electronic Health Records: A National Drug Abuse Treatment Clinical Trials Network Study.
Abstract
Introduction:The use of electronic health records (EHR) data in research to inform
recruitment and outcomes is considered a critical element for pragmatic studies. However,
there is a lack of research on the availability of substance use disorder (SUD) treatment
data in the EHR to inform research. Methods:This study recruited providers who used
an EHR for patient care and whose facilities were affiliated with the National Institute
on Drug Abuse's National Drug Abuse Treatment Clinical Trials Network (NIDA CTN).
Data about providers' use of an EHR and other methods to support and document clinical
tasks for Substance use screening, Brief Intervention, and Referral to Treatment (SBIRT)
were collected. Results:Participants (n = 26) were from facilities across the country
(South 46.2%, West 23.1%, Midwest 19.2 percent, Northeast 11.5 percent), representing
26 different health systems/facilities at various settings: primary care (30.8 percent),
ambulatory other/specialty (26.9 percent), mixed setting (11.5 percent), hospital
outpatient (11.5 percent), emergency department (7.7 percent), inpatient (3.8 percent),
and other (7.7 percent). Validated tools were rarely used for substance use screen
and SUD assessment. Structured and unstructured EHR fields were commonly used to document
SBIRT. The following tasks had high proportions of using unstructured EHR fields:
substance use screen, treatment exploration, brief intervention, referral, and follow-up.
Conclusion:This study is the first of its kind to investigate the documentation of
SBIRT in the EHR outside of unique settings (e.g., Veterans Health Administration).
While results are descriptive, they emphasize the importance of developing EHR features
to collect structured data for SBIRT to improve health care quality evaluation and
SUD research.
Type
Journal articleSubject
Clinical trials networksubstance use assessment
substance use disorder treatment
substance use screening
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https://hdl.handle.net/10161/19376Published Version (Please cite this version)
10.5334/egems.293Publication Info
Wu, Li-Tzy; Payne, Elizabeth H; Roseman, Kimberly; Kingsbury, Carla; Case, Ashley;
Nelson, Casey; & Lindblad, Robert (2019). Clinical Workflow and Substance Use Screening, Brief Intervention, and Referral to
Treatment Data in the Electronic Health Records: A National Drug Abuse Treatment Clinical
Trials Network Study. eGEMs, 7(1). pp. 35. 10.5334/egems.293. Retrieved from https://hdl.handle.net/10161/19376.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Li-Tzy Wu
Professor in Psychiatry and Behavioral Sciences
Education/Training: Pre- and post-doctoral training in mental health service research,
psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns
Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute
on the Design and Conduct of Randomized Clinical Trials.Director: Duke Community Based
Substance Use Disorder Research Program.Research interests: COVID-19, Opioid misuse,
Opioid overdose, Opioid use disorder

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