Sound Outcome Evaluation Will Demonstrate Treatment’s Value

Promoting professional ethics has been a signature aim of the leading national association representing substance use treatment providers. Having played a prominent role in establishing standards to counteract deceptive marketing practices that were tarnishing the field’s reputation, leaders at the National Association of Addiction Treatment Providers (NAATP) knew the next step they had to take to promote high-quality professional practice.

“The next thing we needed to do is look at outcome measurement,” says Annie Peters, Ph.D., executive director of NAATP’s Foundation for Recovery Science and Education (FoRSE). “It’s an ethics issue, to demonstrate that you’re doing what you say you’re doing.”

The commitment of the individuals in recovery who built the treatment field in its early years had helped to reduce stigma around addiction, and this eventually led to broader acceptance of the disease model. But still the field depended too much on anecdote and what seemed to work in treatment, as it promoted its successes. In order for substance use treatment to become a fully integrated component of overall health care, that approach would have to change.

Enter NAATP and its research arm as major influencers of this change. Building on an earlier outcomes pilot project in which a handful of NAATP member facilities participated, leaders of the association realized they needed to launch a broader effort to help build a culture of outcome measurement across the industry.

The FoRSE Treatment Outcomes Program is not designed to promote one organization’s vision for outcome evaluation, or to judge one measurement tool as superior to another. “It’s not necessarily that we want to find the perfect instrument,” said Peters. “We want to focus on the process.”

As of late February, 70 substance use treatment centers are collecting data for the FoRSE project. They are gathering basic information about who their patients are, what services they received, and what their outcome of care was. Patient data are thus collected both during and after treatment, an important factor in an industry where patient evaluation often ends once a client is discharged.

With the data as a guide, “We can then pull apart who is responding to what types of services,” Peters says. The project also will lead to a better understanding of how various social determinants of health affect patient outcomes, she says.

FoRSE developed a database that allows participating treatment centers to submit de-identified data on patient demographics and outcomes. A program overview on the NAATP website states, “We offer a centralized Data Repository and Application Programming Interface (API), allowing data sharing from different technology systems, with the ability to provide confidential site-specific benchmarking reports on the aggregated data. Our interest is in the stories of recovery that are told in data, not in creating new tools and technologies.”

Sigmund Software is linked to the FoRSE database and can help participating customers in any aspect of data collection and reporting. FoRSE participants receive a formal agreement from the outcomes project that clearly delineates how the data will be used.

It is believed this project will help answer some basic questions about treatment, even if it doesn’t lead to full standardization of outcome evaluation across facilities. For example, Peters asks, what is considered a standard “dose” of substance use treatment in a residential setting, or in an outpatient program?

By the end of the first quarter of this year, FoRSE expects to issue a report of 2022 data to participating providers. Also, a summary report with de-identified data will be released to the public soon. “We realize this information is of interest to payers, policymakers and the public,” Peters says. “We hope there is a destigmatizing effect.”

NAATP does not see this project as competing with any other outcome-related initiatives in the field. The more attention this overall issue receives in the industry, the better off everyone will be, Peters and colleagues suggest.

She says reliable outcome evaluation will prove essential to adopting the value-based care models that are gaining traction in the field. For providers to be ready for new payment models, they need an EHR software solution that gives them total control of their data. Our AURA solution is specifically designed for behavioral health professionals and allows for extensive data collection, reporting and analytics.

In already working with many providers who are participating in the FoRSE program, we are proud to be playing a role in an important initiative that will further legitimize the lifesaving work substance use treatment providers perform every day.