How Nudge Tech Helped Halve One City's Overdose Victims
WHY YOU SHOULD CARE
A nudge — provided by a cloud-based app — can go a long way when it comes to treating addiction patients.
By Nick Fouriezos
It wasn’t a flood or a tornado that caused the police chief of Huntington, West Virginia, to call the National Guard on a warm mid-August day in 2016. No, the disaster was a sudden avalanche … of heroin overdoses. Twenty-six in just four hours.
Somehow, against the odds, there were no deaths that day. But the incident woke up the country to what residents here already knew: that the opioid epidemic was in full swing in the Mountain State. West Virginia has the highest rate of overdose deaths in the U.S., and Cabell County, where Huntington is located, had the most overdose deaths of any county in West Virginia two years running: 152 casualties in 2017, and an average of five overdoses per day.
Gripped by the crisis, Huntington — a city of 50,000 that’s been hemorrhaging jobs and people since the 1950s — turned to big data. And it appears to be working. In fact:
After adopting a new patient-tracking tech platform in 2018, Cabell County saw overdoses drop 40 percent in one year.
That turnaround coincides with the decision to enlist Cordata, a technology firm that had previously found success in the Cincinnati area, to fight the opioid crisis. With a program that coordinated efforts of local police, medics and mental health providers, Cordata was able to streamline services — identifying hot spots where support teams should proactively reach out and base operations, and automatically nudging first responders to check back with patients.
While that may seem a simple fix, the results were meaningful for those on the ground. Medical personnel have used the Cordata app to input data quickly to cloud-based software. “The prompts have been valuable,” says Connie Priddy, a quick-response team coordinator for Huntington. There have been multiple instances where patients, who may have refused help on a first visit, ended up agreeing to check in to addiction treatment after a second or third attempt to reach out, she says. “Having that data in front of [the medics] makes them very persistent.”
Nationwide, overdose deaths dropped in 2018 by about 4.4 percent after a record high the previous year, according to the Centers for Disease Control and Prevention. A few states, such as Missouri, Louisiana and Kansas, saw significant increases. But Ohio saw a 23 percent decrease in overdose deaths, while West Virginia as a whole saw a 10 percent drop.
Still, few localities improved so drastically as Huntington. The city’s success proved Cordata’s strategy as “the model of efficacy,” argues the company’s CEO and president Gary Winzenread. West Virginia announced plans in May to expand Cordata to every county. And Ohio, second only to West Virginia in addiction numbers, already has about 25 communities using the quick-response-team model, with a majority of them using Cordata tech. The company also launched the Opioid Response Intervention Network, which includes a dozen community groups across four Midwestern states.
Many communities have long refused to accept outside help, assuming that their problems were unique. “There is too much history, too many patterns of success already out there to ignore them,” Winzenread says. “I’d like to see more interest in following a success pattern rather than feeling like you’re on your own.”
To be sure, tech hasn’t been the only contribution to the stark decrease. The Cabell County health department led efforts to get more doses of naloxone (an overdose reversal drug) to those at risk, likely decreasing overdose calls that required a trip to the emergency room. Addiction treatment programs have seen an uptick as awareness around opioid abuse has increased. “I’m not trying to undersell the product, but I’m always careful to say that the product doesn’t get people the treatment,” Winzenread says. “In all the places we’ve had reductions, we’ve had a number of levers being pulled.”
Still, the early successes have provided hope where there wasn’t much before. In places like Franklin County in Ohio, where Cordata first launched, the county reportedly had only 131 overdose calls and nine opioid deaths by October of last year — compared to 271 overdose calls and 24 opioid deaths in 2017. That program was helped by a $1.5 million grant from Third Frontier, a technology-based economic development fund that used $20 million from the Ohio state budget to address the opioid epidemic. State and federal grants have helped ease gaps in funding for city governments, and so the success of technology platforms like Cordata is in no small part thanks to public investment.
One crucial side effect of using services like Cordata is that first responders are finally getting hard data. Priddy points out that many of her staff previously assumed overdose victims were mostly in their early twenties. After crunching the numbers, though, they now know the average age is actually 36. Small, important details like that could be key in turning the tide against the not-so-natural disaster that is the opioid epidemic — and experts will increasingly rely on technology to help make that fight a fair one.