The System-Wide Medication for Opioid Use Disorder (SW-MOUD) Program: A Description of Program Implementation

Abstract

Medication for opioid use disorder (MOUD) is an evidence-based treatment for opioid use disorder (OUD). However, only a small proportion of eligible patients receive MOUD, due in part to access barriers and the complex medical needs of this population. Provision of MOUD traditionally occurs in ambulatory opioid treatment programs that operate separately from other providers, making it difficult to address patient needs comprehensively during health care encounters. To alleviate these barriers to continuous care for individuals with OUD, The Ohio State Wexner Medical Center designed the System-Wide MOUD (SW-MOUD) program. The SW-MOUD program has two objectives, (a) expand access to MOUD across emergency, inpatient, and outpatient settings, and (b) coordinate care for patients across these settings using integrated program staff. This article describes the SW-MOUD program implementation in order to serve as a roadmap for the creation of similar care delivery mechanisms. In the program’s first 4 years, there were a total of 4,908 MOUD initiations. The implementation tools presented in this article include a patient flow model with an overall program structure, a detailed multilevel implementation timeline, and a table of implementation strategies used across three broad phases: preparation, rollout, and sustainability. The transformation of evidence-based treatments into systematic delivery approaches offers the potential to improve patient outcomes. Our experience is informative not only for health systems seeking to increase access to MOUD in their communities but also for those looking to expand access to care for any treatment modality by coordinating care across existing system silos.