Introduction: Telemedicine use in addiction treatment and recovery services is limited. Yet, because it removes\nbarriers of time and distance, telemedicine offers great potential for enhancing treatment and recovery for people\nwith substance use disorders (SUDs). Telemedicine also offers clinicians ways to increase contact with SUD patients\nduring and after treatment.\nCase description: A project conducted from February 2013 to June 2014 investigated the adoption of telemedicine\nservices among purchasers of addiction treatment in five states and one county. The project assessed purchasers�\ninterest in and perceived facilitators and barriers to implementing one or more of the following telemedicine modalities:\ntelephone-based care, web-based screening, web-based treatment, videoconferencing, smartphone mobile applications\n(apps), and virtual worlds.\nDiscussion and evaluation: Purchasers expressed the most interest in implementing videoconferencing and smartphone\nmobile devices. The anticipated facilitators for implementing a telemedicine app included funding available to pay for\nthe telemedicine service, local examples of success, influential champions at the payer and treatment agencies, and\nmeeting a pressing need. The greatest barriers identified were: costs associated with implementation, lack of reimbursement\nfor telemedicine services, providers� unfamiliarity with technology, lack of implementation models, and confidentiality\nregulations. This paper discusses why the project participants selected or rejected different telemedicine modalities and\nthe policy implications that purchasers and regulators of addiction treatment services should consider for expanding\ntheir use of telemedicine.\nConclusions: This analysis provides initial observations into how telemedicine is being implemented in addiction services\nin five states and one county. The project demonstrated that despite the considerable interest in telemedicine,\nimplementation challenges exist. Future studies should broaden the sample analyzed and track technology\nimplementation longitudinally to help the research and practitioner communities develop a greater understanding of\ntechnology implementation trends and practices.
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