Using Telemedicine To Improve Outpatient Detoxification

Patients who drop out of our treatment program at Kolmac have always been a particular source of concern for myself and my staff. This is especially the case for those people receiving outpatient detoxification because their problem is severe enough to have progressed to the development of withdrawal symptoms.

Now that medication protocols for withdrawal have been improved to the point that symptoms can be quickly eliminated, we look to other areas of improvement to increase the likelihood that patients will complete the detox process and transition into psychosocial treatment such as outpatient alcohol and drug rehab.

At Kolmac, we are exploring ways in which to use telemedicine to address the problem of dropouts. Because isolation is one of the problems that perpetuate addiction, much of treatment is directed toward helping an addicted person connect with people who can promote recovery. The heart of that effort is the promotion of in-person encounters and we are finding that telemedicine can enhance such contact.

We have designed our program so that our patients participate simultaneously in their outpatient rehabilitation program while being detoxified. As a result, over 90% of our patients continue in our program beyond the detoxification process. Of the 10% who do not continue, many are patients who had been planning to continue treatment at a Kolmac office other than the one in which their detoxification is being conducted.

Our previous efforts to build a bridge between offices for these patients centered on describing the other office and providing directions. We have recently begun supplementing this by having patients sit with the detoxification nurse in front of an online camera and computer screen and connect via telemedicine with a clinician at the destination Kolmac office. Our idea is that making a face to face connection with the receiving clinician will have a greater impact than did our previous approach.

The early results in a pilot in one of our two detox offices have been promising. If this continues to be successful we will expand it to our other detoxification site. We are also exploring ways to use telemedicine and other technologies to improve our ability to reduce patient isolation and help them make therapeutic connections with us. I will be describing other examples in upcoming articles.