Wheels and waves: a statewide video directly observed treatment [vdot] program - wheels and waves is a video directly observed treatment [vdot] program that is designed to increase access to methadone…

Wheels and waves: a statewide video directly observed treatment [vdot] program - wheels and waves is a video directly observed treatment [vdot] program that is designed to increase access to methadone and buprenorphine dispensed from opiate use disorder [OUD] treatment programs (known in vermont as "hubs") to vermonters who otherwise are required to travel to the hub site for observed dosing. Through wheels and waves, patients are supplied with secure medication dispensers and a smart phone video APP enabling them to record themselves taking methadone or buprenorphine, and then submit the video for staff observation. The program was successfully piloted at the howard center's chittenden clinic from 2016-2019, significantly reducing barriers to treatment, increasing retention rates, increasing employment rates, and reducing costs for the patient and the state. Vermont care network will administer the samhsa grant allowing the wheels and waves pilot to be expanded statewide making vdot available to patients at all 8 hubs serving vermonters. The overarching goal of wheels and waves is to increase the mat retention rates of up to 400 vermonters with transportation and employment challenges who are accessing methadone and buprenorphine dispensed from hub OUD treatment programs. The statewide implementation will support the following four objectives: 1) by november 30 2022, VCN will have trained 8 hubs in the remote supervised dosing model; 2) by september 29 2023, hubs will have enrolled up to 400 unique individuals in wheels and waves as measured by number of patients who have submitted at least off-site dosing video to the hub's secure platform; 3) by september 29 2023, the retention rate for mat at each hub participating in wheels and waves will be 10% higher than the previous year; and 4) within the 90-day close-out period, VCN will be able to provide average monthly cost and time savings for at least 200 vermonters enrolled in wheels and waves.