Andrey Ostrovsky, MD, FAAP

Even though evidence-based treatment for opioid use disorders (OUD) is effective, almost four in five Americans with OUD do not receive any form of treatment. The gap in access to evidence-based care, including treatment with medications for OUD, stems in part from barriers to change within the health care system. This paper includes nine key barriers that prevent access to evidence-based care, including stigma; inadequate clinical training; a dearth of addiction specialists; lack of… Show more

Even though evidence-based treatment for opioid use disorders (OUD) is effective, almost four in five Americans with OUD do not receive any form of treatment. The gap in access to evidence-based care, including treatment with medications for OUD, stems in part from barriers to change within the health care system. This paper includes nine key barriers that prevent access to evidence-based care, including stigma; inadequate clinical training; a dearth of addiction specialists; lack of integration of MOUD provision in practice; regulatory, statutory, and data sharing restrictions; and financial barriers. Action from a number of actors is urgently needed to address this crisis. Show less

Treatments exist for opioid use disorder, but they are often inaccessible to patients and providers. A new commentary from NAM Perspectives outlines the ways that certain restrictions, stigma, and lack of support are limiting the use of medications to treat opioid use disorder, like buprenorphine. Addressing these barriers could have a significant impact on how addiction treatment is accessed across the country.

Hospital readmissions are a large source of wasteful healthcare spending, and current care transition models are too expensive to be sustainable. One way to circumvent cost-prohibitive care transition programs is complement nurse-staffed care transition programs with those staffed by less expensive nonmedical workers. A major barrier to utilizing nonmedical workers is determining the appropriate time to escalate care to a clinician with a wider scope of practice. The objective of this study is… Show more

Hospital readmissions are a large source of wasteful healthcare spending, and current care transition models are too expensive to be sustainable. One way to circumvent cost-prohibitive care transition programs is complement nurse-staffed care transition programs with those staffed by less expensive nonmedical workers. A major barrier to utilizing nonmedical workers is determining the appropriate time to escalate care to a clinician with a wider scope of practice. The objective of this study is to show how mobile technology can use the observations of nonmedical workers to stratify patients on the basis of their hospital readmission risk. Show less

The historical progression of bundled payments from acute care to post-acute care and the growing recognition of the value of home and community-based services create an interesting opportunity for sustainably integrating medical services with other long-term supports and services (LTSS). With increasing involvement by LTSS providers in care transition programs, there is a growing overlap between traditionally separate medical and LTSS. The low cost and community connectedness of LTSS providers… Show more

The historical progression of bundled payments from acute care to post-acute care and the growing recognition of the value of home and community-based services create an interesting opportunity for sustainably integrating medical services with other long-term supports and services (LTSS). With increasing involvement by LTSS providers in care transition programs, there is a growing overlap between traditionally separate medical and LTSS. The low cost and community connectedness of LTSS providers may give them an advantage over traditional providers of care transition services, especially when their services are augmented by emerging mobile technology. Building on past lessons from efforts to incorporate community-based LTSS into traditional medical care models, such as care transitions, may help to inform successful future strategies to enable bundles to more efficiently achieve the Triple Aim. Show less

"In an era where internet connectivity is ubiquitous and app proliferation is unprecedented, a fertile environment exists to augment existing and emerging care transition models using mobile technology..."

The Innovations Exchange is a comprehensive program designed to increase the development and adoption of innovations in health care delivery and policy, and contains more than 875 searchable Innovation Profiles and 1,525 QualityTools.

The intent of this IHI Innovation Project was to scan for health technology innovations that will provide the greatest value to health systems working to achieve the IHI Triple Aim: simultaneously improving the patient experience of care, improving the health of populations, and reducing the per capita cost of health care.

As the health care landscape shifts toward population health management and enacted policies work to curb the rising cost of health care, emerging digital health… Show more

The intent of this IHI Innovation Project was to scan for health technology innovations that will provide the greatest value to health systems working to achieve the IHI Triple Aim: simultaneously improving the patient experience of care, improving the health of populations, and reducing the per capita cost of health care.

As the health care landscape shifts toward population health management and enacted policies work to curb the rising cost of health care, emerging digital health technologies should seek to realize the Triple Aim.

Using validated approaches to software selection, we created a Digital Health Selection Framework (DHSF) to guide patients, providers, and payers through the procurement of technology to help them achieve the Triple Aim. Show less

mHealth Technology: Tablet-based Point of Care Surveys with Real-Time Triage Support. Goals Achieved: 1. 39.6% reduction in readmissions 2. $370,721 in net savings over 6 months 3. 257% ROI in technology. Setting: Elder Services Merrimack Valley, Lawrence, MA

Academic medical centers (AMCs) have the potential to be leaders in the era of healthcare delivery reform, but most have yet to display a commitment to delivery innovation on par with their commitment to basic research. Several institutional factors impede delivery innovation including the paucity of adequate training in design and implementation of new delivery models and the lack of established pathways for academic career advancement outside of research...

Two dads, a pediatrician and a web designer, write a charming, age-appropriate book to instill an early love of code for kids under 5

Experts at Boston Children’s Hospital explore how the right technology can dramatically improve healthcare for children with chronic conditions by streamlining the monumental task of coordination between healthcare providers, parents and children’s extended care networks.

23(1): 297.

Resolution aligning the San Francisco Department of Public Health priorities to the 10 consensus issue areas of the San Francisco Community Vital Signs

32(6): 521.