Lecture – Using Data to Improve Quality of Care for Substance Use Disorders

Presented by Alisa Busch, MD, MS, McLean Hospital, 2021 Jack H. Mendelson Memorial Research Award honoree.

A 2019 Substance Abuse and Mental Health Services Administration report found that 7.7% of Americans had a substance use disorder. Nearly 4% had both a substance addiction and other mental illness. Other recent studies show increasing rates of alcohol use disorder, opioid overdoses, and other substance use issues.

Faced with these problems, clinicians and health care systems are looking for new ways to measure and improve addiction care.

In her talk, McLean’s Alisa Busch, MD, MS, explores how health care quality frameworks and advanced analytics could lead to better treatments and outcomes.

Presentation highlights include:

• A detailed explanation of the differences between structure, process, and outcomes of care and the value of each in assessing health care quality
• A review of the various aspects of care that can be used to assess health care quality
• A discussion of the components of a “learning health care system” and how these components can be used to improve care quality

Busch points out that the U.S. spends more than other nations on health care. However, quality levels are lower for many conditions, including addiction to drugs and alcohol.

Quality care frameworks, she says, can help us better understand quality levels and find ways to improve. She examines the Donabedian and Institute of Medicine quality frameworks. These models check areas such as staffing levels, use of electronic medical records, safety, and efficiency. Both can be applied to care focused on substance use disorders to point out areas for improvement.

In addition to quality care frameworks, Busch looks at learning health care systems. Such systems bring together science information, incentives, and culture. Together, these elements spark innovation, quality improvement, and the development of best practices.

The integration of new technologies, biases in health data reporting, and other issues make these systems difficult to create. Still, she says, they hold great promise for improvement, particularly with substance addiction patient populations.

“We have increasingly new types of data and opportunities to measure and improve care,” Busch says. Although these opportunities present challenges for mental health professionals, she says that “we don’t need to wait until we work out all of those kinks before doing a lot of really good work.”