A telehealth addiction consult service program for hospitalized patients with substance use disorders is as effective as in-person consults.
The COVID-19 pandemic prompted rapid adaptations in health care delivery, including the adoption of telehealth services for addiction treatment. This study investigated the feasibility and effectiveness of transitioning an in-person hospital addiction consult service (ACS) program at Stanford Hospital, in Palo Alto, California, to a telehealth-based ACS program. ACS are offered to patients who may have or disclose having a substance use disorder (SUD) during an in-patient hospitalization. These services often facilitate referrals and linkages to more comprehensive, specialty SUD services and treatment options.
The authors reported that more telehealth ACS consults were completed than in-person consults, with 370 unique patient consults in the year prior to the COVID-19 pandemic and 473 unique patient consults in the first year after the pandemic began. For patients with a history of repeat hospital admissions, ACS reduced 30-day readmission over the six months following the initial consult in both in-person and telehealth ACS delivery, demonstrating that transitioning to telehealth delivery does not impact program effectiveness. Nurse support, an efficient workflow, access to HIPAA-compliant devices, and adaptations in federal regulations related to care provision in response to COVID-19 were all factors that contributed to the successful implementation of telehealth ACS in an in-patient setting.
Results from this study offer promising evidence to support the telehealth delivery of ACS for hospitalized patients. The study also indicates potential to extend addiction evaluation and treatment services, particularly in underserved areas, and could play a valuable role in addressing the ongoing addiction epidemic.