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Table 4 Anticipated facilitators and barriers

From: Trends in telemedicine use in addiction treatment

State Technology Facilitators Barriers
Iowa Web-based Computerized Treatment (Recoveration) Initial funding through SAMSHA TCE Grant Agency concerns with technology
  NIATx Improvement Collaborative Agency inexperience with technology
Treatment agency champion  
Massachusetts Smartphone Mobile Device (A-CHESS) Existing example of successful application (A-CHESS) Identifying start-up funding
Web Screening (Drinkers Check-up) Potential case rate funding model Lack of funding for reimbursement
Concerns with meeting HIPAA & 42CFR regulations
Maryland Videoconferencing (telesuboxone) Strong champion (state governor) Lack of willing and available MDs for suboxone prescribing
Limited funding for reimbursement
Limited models to follow
Oklahoma Smartphone Mobile Device (A-CHESS) Smartphone Mobile device start-up funding is available Limited reimbursement model
Expanded Videoconferencing Medicaid expansion covered clinical services for videoconferencing  
San Mateo County Videoconferencing (telesuboxone) Demonstrated need for greater MD coverage to address opiate addictions Competing priorities (ACA implementation)
   Lack of start-up funding
Lack of funding for reimbursement
HIPAA compliance concerns
South Carolina Videoconferencing (telepsychiatry & telesuboxone) SSA Director Champion Competing priorities (significant changes in environment)
Smartphone Mobile Device (A-CHESS) Psychiatrist/ physician availability