Montefiore Health System created this toolkit for its prescribers and staff to manage access to opioid use disorder (OUD) treatment including medications during the COVID-19 pandemic. This toolkit includes the following materials that may serve as templates for other hospital systems or clinician practices during this national emergency:
- Policies created by Montefiore Health System for its prescribers and health care providers:
- Clinical and regulatory guidance:
- The American Society of Addiction Medicine’s guidance for continuing buprenorphine treatment during COVID-19
- A FAQ publication on treating OUD during the pandemic from Provider Clinical Support Systems
- Guidance from the Substance Abuse and Mental Health Services Administration on patient privacy protections for substance use disorder (SUD) services under CFR 42 Part 2 during the COVID-19 public health emergency
- Information for clinicians on using telemedicine to prescribe controlled substances during the pandemic from the Drug Enforcement Administration
- FAQs about Health Insurance Portability and Accountability Act (HIPAA) enforcement discretion from the U.S. Department of Health and Human Services
- Patient guides:
- A 1-page patient tip sheet for maintaining buprenorphine treatment and an additional document with patient instructions
- A 1-page English and Spanish language patient guide for safely managing take home doses of methadone
- Buprenorphine home induction guides in English and Spanish
- Mental Health and Stress Reduction Resources for both patients and health care providers:
- A 12-page guide to using principles from Acceptance and Commitment Therapy (ACT) to manage stress during the pandemic
- A 3-page guide to creating calm by practicing mental, physical and soothing grounding exercises
- A visualization exercise to help manage negative thinking
- A 1-page summary of strategies for managing stress
- A 4-page guide to reducing stress from the New York State Office of Mental Health
- A 1-page infographic explaining the STOP method for reducing stress
- EPIC Templates for electronic health records notes for telemedicine visits including:
Montefiore Buprenorphine Treatment Network COVID-19 Response Memo
Source: Montifiore Health Systems
This memo outlines policies adopted by Montifiore Health System to continue patient access to buprenorphine treatment during the COVID-19 pandemic.
Provider Guide to Buprenorphine Treatment during COVID-19
Source: Montifiore Health System
This 1-page guide from Montifiore Health Systems guides providers in prescribing buprenorphine during the COVID-19 pandemic. This information sheet discusses telemedicine best practices and changes in regulatory guidance during the pandemic,
Buprenorphine Treatment During COVID-19 Pandemic
Source: Project ECHO - Montifiore Health System
These presentation slides from a Project ECHO session at the Montifiore Health System details treatment of opioid use disorder (OUD) during the COVID-19 pandemic.
How to Video Call Patients/Families through Apple FaceTime
Source: Montifiore Health System
This 1-page document provides a step-by-step guide for clinicians using Apple Face Time to consult with patients during the COVID-19 pandemic.
COVID-19: Supporting Access to Buprenorphine
Source: American Society of Addiction Medicine
This resource from the American Society for Addiction Medicine (ASAM) gives guidance on providing access to buprenorphine for patients treated for opioid use disorder in primary care and outpatient settings during the COVID-19 pandemic.
Frequently Asked Questions (and Answers!): Treating Opioid Use Disorder via Telehealth Tips for Primary Care Providers
Source: Providers Clinical Support System
This 4-page guide from the Providers Clinical Support System is designed to provide information for clinicians on using telemedicine to treat opioid use disorder (OUD) during the COVID-19 pandemic. This guide includes frequently asked questions about prescribing medications for OUD during this time,
COVID-19 Public Health Emergency Response and 42 CFR Part 2 Guidance
Source: Substance Abuse and Mental Health Services Administration
This guidance from the Substance Abuse and Mental Health Services Administration addresses patient privacy protections for substance use disorder (SUD) services under CFR 42 Part 2 during the Covid-19 public health emergency.
DEA Information on Telemedicine (COVID-19)
Source: U.S. Drug Enforcement Agency
This 1 page fact sheet from the Drug Enforcement Administration clarifies that during the Covid-19 public health emergency prescribers will be able to use telemedicine to evaluate a patient and prescribe schedule II-IV drugs.
FAQs on Telehealth and HIPPA during the COVID-19 Nationwide Public Health Emergency
Source: U.S. Department of Health & Human Services
This guidance from the U.S. Department of Health and Human Services provides clarification on the provision of telehealth during the Covid-19 public health emergency.
Patient Tip Sheet: Buprenorphine Treatment During Coronavirus
Source: Montifiore Health System
This 1-page patient guide to buprenorphine treatment from Montifiore Health System, created specifically for care during the COVID-19 pandemic, discusses how clinicians will maintain treatment though telephonic visits, provides advice on stress reduction and avoiding relapse, and offers recommendations to ensure patient safety and health.
COVID-19 Guidance for Patients Engaged in Buprenorphine Treatment at Montifiore
Source: Montifiore Health System
This resource from Montifiore Health System provides a 1-page guide for patients receiving buprenorphine treatment for opioid use disorder during the COVID-19 pandemic.
Patient Tip Sheet: Take Home Doses of Methadone- English and Spanish Language
Source: Montifiore Health System
This 1-page patient guide focuses on safe use of methadone take home doses during the COVID-19 pandemic. Includes both English and Spanish language versions.
Buprenorphine Home Induction Instructions for Patients
Source: Montifiore Health System
This 2-page guide is designed for patients who are beginning buprenorphine treatment for opioid use disorder at home under the guidance of their prescriber.
Buprenorphine Home Induction Instructions for Patients – Spanish
Source: Montifiore Health System
This 2-page Spanish language guide is designed for patients who are beginning buprenorphine treatment for opioid use disorder at home under the guidance of their prescriber.
Face COVID: How to Respond Effectively to the Corona Crisis
Source: Dr. Russ Harris
This 12-page guide assists patients with coping during the COVID-19 pandemic from Dr. Russ Harris. The guide draws upon acceptance and commitment therapy (ACT) principles to help people FACE COVID by:
Patient Instructions on Grounding to Create Personal Calm
Source: Montifiore Health System
This 3-page guide provides patients information on reducing stress during the COVID-19 pandemic by creating personal calm through grounding.
Leaves on a Stream Visualization Exercise
Source: Dr. Russ Harris
This 1-page guide provides a visualization exercise to help patients manage stress during the COVID-19 pandemic. The visualization exercise is based on the acceptance and commitment therapy (ACT) model and is intended to help patients manage negative thinking.
Guidance for Functioning During a Crisis
Source: Montifiore Health System
This 1-page guide from the Montifiore Health System provides information on managing stress and maintaining function during the COVID-19 pandemic. The information is based on acceptance and commitment therapy (ACT) treatment models.
Feeling Stressed about Coronavirus (COVID-19)? Managing Anxiety in an Anxiety Provoking Situation
Source: New York State Department of Mental Health
This 4 page guide from the New York State Office of Mental Health addesses approaches to reducing stress during the COVID-19 pandemic.
The STOP Practice
Source: Montifiore Health System
This 1-page infographic explains the STOP practice for reducing stress. Part of a collection of stress reduction materials compiled by Montifiore Health System for their patients during the COVID-19 pandemic.
EPIC Template: Buprenorphine Treatment Telephonic Intake Visit
Source: Montifiore Health System
This document provides a template for an EPIC electronic health record note for a prescriber inducting a patient onto buprenorphine through telemedicine during the COVID-19 pandemic.
Epic Template: Buprenorphine Treatment Telephonic Visit for Existing Patient
Source: Montifiore Health System
This document provides a template for an EPIC electronic health record note for a clinician providing a telemedicine visit for a continuing patient treated with buprenorphine for opioid use disorder during the COVID-19 pandemic.
EPIC Template: Buprenorphine Treatment Coordinator Telephonic Visit
Source: Montifiore Health System
This EPIC electronic health record template note is designed for a buprenorphine treatment coordinator offering services through telemedicine during the COVID-19 pandemic.
EPIC Template: Telemedicine Documentation in Progress Notes
Source: Montifiore Health System
This document provides a template for an EPIC electronic health record note for documenting that the service was provided via telemedicine due to the COVID-19 pandemic.