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Health information technology’s (IT’s) ability to improve patient care and reduce cost is limited by the inability to implement targeted technologies. Despite the apparent importance of payers/regulators, research on their readiness to support a targeted health IT is limited. This proposal will test the P-RTI assessment tool’s ability to prospectively predict health IT use rates. This tool was developed at the University of Wisconsin-Madison Center for Health Enhancement Systems Studies (CHESS) using data from six payer-based health IT adoption pilots conducted by CHESS and an extensive review of health IT adoption research.

The Need

Factors found to influence health IT adoption and use include health IT characteristics, user preferences, organizational context, and the payer/regulatory environment. These factors have been studied intensely with explanatory models to predict their effects, with one exception: the payer/regulatory environment.


The proposed trial will test the application of the P-RTI tool to explain health IT adoption of two addiction treatment technologies, telephonic and video therapy. In telephonic therapy, a counselor (typically sitting in his or her office) interacts with a patient in a remote location. Telephonic therapy increases access to treatment for patients living in rural areas or those who have transportation difficulties. It also allows brief spontaneous interactions between clinician and patient that can prevent an addiction relapse. Video therapy occurs through a secure Internet portal by personal computer or a dedicated telemedicine site. In instances of dedicated telemedicine equipment use, it requires that both the patient and provider converse from a location with telemedicine equipment. Video therapy increases patient access in the same ways as telephonic therapy and also provides access to limited clinical resources. In the SAMHSA pilot, two states implemented video therapy to provide access to difficult-to-reach specialty addiction medication prescribers and adolescent psychiatrists. In those situations, the patient was located at the local addiction treatment agency and the clinician at a remote location.
Both telephonic and video-therapy provide the means to replace, or be used in conjunction with, traditional in- person treatment. The technologies were selected for this study because they are the most common technologies addiction treatment agencies are trying to implement, and there remains considerable variation in adoption of these technologies. The dependent variable for the study is the P-RTI score, and the study’s primary outcome is the percentage of patients using these targeted technologies.

Funding Period:
July 1, 2015 - June 30, 2017
Principal Investigators:
Todd Molfentor, Ph.D
Todd Molfentor