Table 4 Anticipated facilitators and barriers
State | Technology | Facilitators | Barriers |
|---|---|---|---|
Iowa | Web-based Computerized Treatment (Recoveration) | Initial funding through SAMSHA TCE Grant | Agency concerns with technology |
| Â | NIATx Improvement Collaborative | Agency inexperience with technology | |
Treatment agency champion | Â | ||
Massachusetts | Smartphone Mobile Device (A-CHESS) | Existing example of successful application (A-CHESS) | Identifying start-up funding |
Web Screening (Drinkers Check-up) | Potential case rate funding model | Lack of funding for reimbursement | |
Concerns with meeting HIPAA & 42CFR regulations | |||
Maryland | Videoconferencing (telesuboxone) | Strong champion (state governor) | Lack of willing and available MDs for suboxone prescribing |
Limited funding for reimbursement | |||
Limited models to follow | |||
Oklahoma | Smartphone Mobile Device (A-CHESS) | Smartphone Mobile device start-up funding is available | Limited reimbursement model |
Expanded Videoconferencing | Medicaid expansion covered clinical services for videoconferencing | Â | |
San Mateo County | Videoconferencing (telesuboxone) | Demonstrated need for greater MD coverage to address opiate addictions | Competing priorities (ACA implementation) |
| Â | Â | Lack of start-up funding | |
Lack of funding for reimbursement | |||
HIPAA compliance concerns | |||
South Carolina | Videoconferencing (telepsychiatry & telesuboxone) | SSA Director Champion | Competing priorities (significant changes in environment) |
Smartphone Mobile Device (A-CHESS) | Psychiatrist/ physician availability | Â |