A learning health system model for addressing substance use: Denver Health Center for Addiction Medicine

Abstract

Introduction

Substance use disorders (SUDs) continue to place heavy burdens on patients, health systems, and communities. Rapidly evolving treatment for SUDs requires health systems that can efficiently and effectively assess data and integrate evidence to practice. This paper describes the implementation of a learning health systems model of SUD care at an urban, safety-net, integrated health system in Denver, Colorado.

Methods

The health system created the Center for Addiction Medicine (CAM) to coordinate comprehensive services for patients with SUD, including research, evaluation, and quality improvement efforts. CAM implemented a hub-and-spoke model of care and developed four strategic areas to identify, integrate, and grow SUD services. CAM also created a process for engaging community members with lived experience with SUDs and a CAM Academy to educate partners within the health system and across the region.

Results

CAM successfully implemented processes for gathering and assessing evidence, informing clinical practice, fostering community partnerships, and strategically expanding services and reach. Key factors driving success include strategic planning, leadership buy-in, data infrastructure, and community partnerships.

Conclusions

Integrated SUD care at a safety-net institution is a continued challenge. Persistent barriers include the SUD policy and regulatory landscape, addressing co-occurring social and health circumstances when treating SUDs, and accurate clinical documentation of SUDs. Applying a learning health system model can help health systems adapt to these challenges.