Hungry to Get Better: Part 2
PublishedOctober 10, 2021
Andrew Le, MD: With the opioid epidemic happening during a pandemic, what's surprised you most?
Opioid related deaths have increased exponentially during the COVID pandemic. Image of Oxycodone courtesy of WBNS. https://www.10tv.com/article/news/local/medical-experts-discuss-impact-of-covid-19-pandemic-on-opioid-epidemic-in-ohio/530-184470ce-070a-4d1f-a69d-efc5c978ea1c
Colleen Nicewicz: What surprised us most was the success of virtual care. We had always assumed that virtual care was not an option for us for a couple reasons. First, the regulatory environment wouldn't accommodate it. Second, we didn't know that our members had the technical acumen to receive care that way. What we learned—literally overnight—is that everybody has a phone, everybody can figure out Zoom after a couple of times, and that we can deliver clinical outcomes comparable to in-person care.
Early in the pandemic, we understood some of the key benefits of virtual care. It removes a lot of barriers to treatment. Many people we serve don't have a driver's license or the ability to get to treatment. Dialing in from a couch increased their willingness to attend.
At the same time, there's still a market for delivering care in person. So we are going to move forward with a hybrid approach. We think that's best for our members. Our payer partners are aligned there as well.
Andrew: What do you think, post-pandemic, will be the split between virtual and in-person care?
Colleen: We're in the process of asking our membership base to pick a path. Right now, the split looks like it’s going to start at 50/50. Over time, it might skew closer to 60/40 in favor of virtual care. But especially in the group setting, there's a lot of value to being in a room of people with shared experiences, so we're going to continue to support both models.
Andrew: Have state-by-state regulations affected the move to virtual care?
Colleen: A little bit. Prior to the pandemic, many places in the U.S. required that the first interaction with a provider be in person. That requirement was rolled back because of COVID, and in most places is still rolled back, except in one of our markets.
It's unclear when states will start making any moves. My hope, and the hope of many providers I know, is that we can continue to deliver care virtually in a way that has great controls, is high quality, and keeps people safe.
"My hope... is that we can continue to deliver care virtually in a way that has great controls, is high quality, and keeps people safe."
Andrew: When I was in med school, my last rotation was at a clinic specializing in treating people recovering from opioid addiction. As I sat in those treatment groups, I was astounded by how hard it was for people to get there—even in a city like Boston that's walkable and has a lot of public transit.
Colleen: Getting to treatment is one challenge. Then there’s figuring out where the high-quality treatment providers are when you feel ready. We think very hard about how to get in front of people who would benefit from our treatment. Today, about a third of our intake volume comes from referrals from people currently in the program. Another third of our volume comes in digitally, and the other third comes through community partners like emergency departments and the correctional system. Getting people to our front door is sometimes the hardest part. So we are trying something new. We just partnered with our first influencer.
Andrew: Getting people to the front door of care is the thing that we're trying to solve at Buoy. It’s a fascinating challenge. What kind of influencer are you working with? And how are people finding you digitally?
Colleen: Digitally, people mostly engage with us through Facebook. From an influencer perspective, we found someone with an impressive story and social media presence. She was addicted to opiates for several years, ended up in prison like so many of the people we serve, and is now devoting a lot of her time to educating people. She has a huge following on TikTok and YouTube. We'll see if partnering with her helps generate awareness of our services. Our goal is to be there when people need help.
Andrew: We share a team presence in Boston. Any thoughts on how the city can use its policies to curb the opioid epidemic?
Colleen: It’s important to have great treatment options with rapid intake available. It’s important to have first responders and law enforcement available to administer life-saving treatment like Narcan. But once you’re able to stabilize and help people manage their addictions, what’s next?
We spend a lot of time at Groups helping people meet their personal goals. Whether it's getting a job or a car or finishing school, we make sure people have community-based resources to help get their lives back. Without a community network, the risk of relapse is heightened.
Andrew: What excites you most when you think about the technologies and clinical breakthroughs happening in addiction treatment?
Colleen: There are so many people flooding to the digital health market right now. If I had that magic wand, I would find the right balance between in-person care and the complimentary services delivered through engaging technologies. That’s what we're in the process of building right now. We see our patients for an hour every week. But there are so many more opportunities to engage outside of that treatment window that can help people stay on track as they navigate their recovery.
"If I had that magic wand, I would find the right balance between in-person care and the complimentary services delivered through engaging technologies."
About the participants:
Colleen Nicewicz is the CEO of Groups Recover Together, an organization delivering opioid addiction recovery services that are proven to help individuals get their lives back on track.
Andrew Le, MD, is the CEO and Co-founder of Buoy Health.