The needed breakthrough may be just around the corner with the development of an online dashboard DrugTRAC, which uses an AI-powered algorithm to synthesize information provided from statewide lab records �鶹��Ʒ S� allowing for nearly real-time insights on the local drug supply.

�鶹��Ʒ S�Even though I �鶹��Ʒ S�m an administrator, this research is something I think I �鶹��Ʒ S�ll always be involved in because it is so important, �鶹��Ʒ S� she says. �鶹��Ʒ S�This is how we save lives �鶹��Ʒ S� by reaching out and doing things proactively instead of retrospectively. �鶹��Ʒ S�

This initiative was created through Project Overdose, a community-based nonprofit focused on combating overdoses resulting from the opioid and drug epidemic that Cortelyou worked with for six years. Formerly called Project Opioid, Project Overdose partners with local business, faith, philanthropy and public health leaders to address substance use in Florida.

How DrugTRAC Works

Cortelyou collaborated with tech developer Social Innovation Technologies to help design DrugTRAC, which stands for tracking, reporting, advocacy and coordination. The data, which is anonymized and privacy-protected, relies on routine lab tests like urine and toxicology screens to offer researchers new insights into which substances are circulating in Florida communities.

�鶹��Ʒ S�One of the biggest challenges in this field is that we �鶹��Ʒ S�ve always been behind, �鶹��Ʒ S� Cortelyou says. �鶹��Ʒ S�The only real data about what is happening in the drug supply in your community has been from mortality data, which takes almost 12 to 18 months to get after someone dies from an overdose. That means you �鶹��Ʒ S�re dealing with yesterday �鶹��Ʒ S�s problem. If you’re trying to make decisions based on trends that were happening a year ago, you’re always behind. �鶹��Ʒ S�

The dashboard compiles nightly drug-screen results and tracks more than 90 different substances before mapping emerging trends down to the ZIP code level. That information can then be used to alert community leaders and first responders to potential spikes and co-occurring substances, like the presence of fentanyl in cocaine.

DrugTRAC �鶹��Ʒ S�s Current and Future Impact

The tool recently detected the presence of carfentanil, an extremely dangerous synthetic opioid that is nearly 1,000 times more potent than morphine and 100 times more than regular fentanyl. It could require four or five administrations of Narcan to revive someone from a fatal overdose, making it crucial that first responders and community leaders are alerted to any presence in the community.

However, artificial intelligence will take the tool �鶹��Ʒ S�s impact to the next level. Cortelyou and the Social Innovation Technologies team anticipate being able to launch a more proactive approach with the help of AI in the next six months. By integrating an innovative, AI-powered algorithm into the system based on a range of data �鶹��Ʒ S� including economic indicators, major events, arrest records and time of year �鶹��Ʒ S� to predict future trends. That information can be used to provide early warnings to hospitals, emergency medical services, law enforcement and community organizations.

�鶹��Ʒ S�I’m working with the programmer to help them identify the data sources that will feed into the algorithm, like the factors that cause spikes in drug usage, �鶹��Ʒ S� Cortelyou says. �鶹��Ʒ S�The dream is that once this system becomes predictive, we �鶹��Ʒ S�ll be better prepared and able to say, �鶹��Ʒ S�Hey, in the next couple of weeks, we’re expecting to see X, Y and Z happen in your community. Get ready. �鶹��Ʒ S� �鶹��Ʒ S�

Cortelyou says they are also currently investigating ways to make the alerts and information more accessible, like social media content targeted toward younger, more at-risk age groups.

Ultimately, Cortelyou hopes this technology can help communities get ahead of drug overdoses and help communities respond faster than ever before.

Since 2015, at least five states have passed laws requiring emergency departments to provide additional support for opioid overdose patients, such as initiating MOUD treatment. Over the next five years, and her research team will examine whether state policies that mandate evidence-based treatments for opioid use disorder ultimately save lives.

Opioid use disorder is a life-threatening health condition that affects more than 2 million people in the U.S.

For those experiencing opioid overdose, MOUDs like buprenorphine and methadone can reduce the risk of death by 50%.

An associate professor in the College of Community Innovation and Education �鶹��Ʒ S�s , Andraka-Christou focuses much of her research efforts on expanding access to life-saving medications for substance use disorder.

Expanding Life-Saving Care

Funded by a five-year, $3.5 million NIH grant, Andraka-Christou is collaborating with University of Michigan health economist and multiple principal investigator Thuy Nguyen on this legal epidemiology project. Using policy surveillance and difference-in-difference analyses, they �鶹��Ʒ S�ll assess how state emergency department laws affect patient health outcomes. The findings could inform broader development, refinement and implementation of similar policies, ultimately improving care for people experiencing overdose and helping prevent future overdoses.

She adds that the specific requirements of each law may make a difference. For example, an overdose patient who �鶹��Ʒ S�s handed a phone number for an addiction clinic may be less likely to connect and continue receiving treatments than someone who �鶹��Ʒ S�s provided with an MOUD in the emergency department and guided through setting up an appointment in the community, she says.

�鶹��Ʒ S�It’s one thing to start someone on MOUDs, but an emergency department is a unique setting, �鶹��Ʒ S� Andraka-Christou says. �鶹��Ʒ S�We don’t want people to have to repeat the cycle and keep going back to the emergency room. There needs to be an intermediary step �鶹��Ʒ S� perhaps a warm handoff to a primary care doctor, an addiction clinic or a methadone clinic �鶹��Ʒ S� so that they can continue to see that person after initial treatment. That �鶹��Ʒ S�s currently a big gray area, and outcomes can potentially depend on how prescriptive these laws are. �鶹��Ʒ S�

Building a First-Of-Its-Kind Database

Andraka-Christou and her team are creating a longitudinal database of all state statutes, regulations and executive orders effective between 2014 and 2024 related to facilitating MOUD use after emergency department visits for opioid overdose. This requires assessing thousands of laws for relevance before interpreting legal jargon, summarizing and transforming them into a quantitative policy dataset.

The team will then use three sets of claims data �鶹��Ʒ S� Medicaid, Medicare and commercial insurance �鶹��Ʒ S� to describe trends in MOUD initiation and retention rates after emergency department visits, examining the effects of different policies. Researchers will also comb through the data to find and describe key patient, provider, geographic and demographic characteristics associated with treatment after these visits. Such factors include rurality, income level and covariates like age or co-occurring conditions.

�鶹��Ʒ S�With overdoses, there are so many claim codes that are relevant, such as poisoning, intoxication and overdose, �鶹��Ʒ S� Andraka-Christou says. �鶹��Ʒ S�They �鶹��Ʒ S�re also divided by the type of opioid. Within all of these, we will also examine the type of medication that they’re receiving �鶹��Ʒ S� such as methadone, buprenorphine or naltrexone �鶹��Ʒ S� and how any legal issues surrounding them influence retention. We’ll need to look at differences in effects of the law by type of poisoning, and there might also be variation in the effects of these laws depending on each population of insurance. �鶹��Ʒ S�

Shifting How Standards of Care Are Enforced

Andraka-Christou says that at a higher level, the project should provide an interesting analysis of what happens when state law requires specific action in medicine. Instead, best practices may not occur until patients or their families initiate malpractice lawsuits for violation of the standard of care �鶹��Ʒ S� something that also requires health literacy and legal knowledge to do. If top-down state laws in this study are found to be effective at increasing the use of evidence-based treatment, they could serve as catalysts for a paradigm shift in how quality of care is enforced in hospitals.

�鶹��Ʒ S�If we find that the states that implemented a law requiring MOUD provision see more opioid-use disorder patients staying on the medications, that bodes well and could have massive implications for public health, �鶹��Ʒ S� she says. �鶹��Ʒ S�At that point, there �鶹��Ʒ S�s a good argument to be made that, for this situation and population, we may need to take a more top-down approach to enforce the standard of care. �鶹��Ʒ S�

Researcher Credentials

Andraka-Christou received both her juris doctorate and Doctor of Philosophy in law and social science from Indiana University Bloomington. She is a licensed attorney. She joined UCF �鶹��Ʒ S�s School of Global Health Management and Informatics in 2017 and holds a joint secondary appointment in the College of Medicine. Her areas of expertise include health services, health policy and substance use disorder treatment. Andraka-Christou also leads UCF �鶹��Ʒ S�s  research team.

Challenges With Quality of Care

Chisholm, an associate professor in the College of Community Innovation and Education �鶹��Ʒ S�s , studies nursing home residents living with advanced dementia. She says many facilities struggle to identify the right end-of-life-care transition time due to lack of resources caused by differences in reimbursement.

�鶹��Ʒ S�The way nursing homes are reimbursed creates a two-tiered system, �鶹��Ʒ S� Chisholm says. �鶹��Ʒ S�You have nursing homes paid for privately or through Medicare, where the reimbursement is higher, and nursing homes with mostly Medicaid residents, where the reimbursement is lower. When you have this difference in reimbursements, you have differences in resources available to facilities, which creates imbalances in quality of care. �鶹��Ʒ S�

But there �鶹��Ʒ S�s also another issue at hand �鶹��Ʒ S� a lack of discussions taking place about hospice options. Chisholm says these conversations can be challenging for patients, families and nursing home staff alike.

�鶹��Ʒ S�We don �鶹��Ʒ S�t like to talk about death, even though it �鶹��Ʒ S�s going to happen to all of us, �鶹��Ʒ S� Chisholm says. �鶹��Ʒ S�Staff may not feel knowledgeable enough to have these discussions, and patients and their families may have �鶹��Ʒ S� religious [beliefs or perspectives based on their backgrounds] that make them uncomfortable with the subject. �鶹��Ʒ S�

While these conversations may be difficult, they are important. Chisholm says patients who never express their wishes for end-of-life care leave those big decisions to their families and care providers.

�鶹��Ʒ S�Many patients with advanced dementia can no longer speak for themselves, and family members are usually proxies to discuss their care needs, �鶹��Ʒ S� Chisholm says. �鶹��Ʒ S�When you �鶹��Ʒ S�re no longer able to speak for yourself and you haven �鶹��Ʒ S�t expressed your wishes, your family can only assume what you want. You could end up receiving unnecessary care that neither improves your quality of life nor helps you live longer. �鶹��Ʒ S�

Resources for Support, Communication and Planning

Inspired to foster this critical dialogue and help prepare dementia patients for a smoother transition, Chisholm and a cross-collaborative team are working with nursing homes to establish a standardized process for determining when to transition residents into hospice. Through a series of stakeholder interviews, the team proposed using the Mitchell Index �鶹��Ʒ S� a data-collecting tool that calculates the mortality risk of dementia patients �鶹��Ʒ S� to predict which residents have the greatest need for advanced-care planning conversations, helping staff give those residents a timely opportunity to discuss their desires.

Chisholm says the care providers the team has worked with have responded positively, indicating that the Mitchell Index could be successfully adapted for use in long-term care settings. Now, they need a tool to help promote and facilitate end-of-life-care planning conversations �鶹��Ʒ S� and that �鶹��Ʒ S�s where her research comes in.

�鶹��Ʒ S�One nursing home found that the Mitchell Index facilitated their need to have discussions about advanced-care planning, and they want more information on how to do that, �鶹��Ʒ S� Chisholm says. �鶹��Ʒ S�Our next step is to link the Mitchell Index study with my research, which talks about promoting goals-of-care discussions. Combining these two will create a full picture and help us give people a more comfortable, respectful death. �鶹��Ʒ S�

Going forward, Chisholm says the goal of her research is to improve the quality of care for all nursing home residents.

�鶹��Ʒ S�In the last 10 to 20 years, we �鶹��Ʒ S�ve seen a shift in nursing homes from hospital-like care to more of a home-like environment, �鶹��Ʒ S� Chisholm says. �鶹��Ʒ S�I love this move toward person-centered care �鶹��Ʒ S� really trying to understand who the resident is, listening to them, and focusing not just on their physical needs but on their overall well-being. Nursing homes often get a bad rap, and there �鶹��Ʒ S�s a lot we can do to improve both the quality of care and how people perceive them. �鶹��Ʒ S�

Epic is an electronic health record system commonly used by hospitals and physician practices, with more than 325 million patients in its databases. To learn how to use Epic, you typically must be employed at a company that utilizes it. However, by teaming up with Orlando Health, students now have access to Epic via a training program created by Orlando Health information technology (IT) and clinical engineering (CE) learning leadership to give them a head start.

�鶹��Ʒ S�Epic is an electronic health record system that’s used nationally by most of the big players in healthcare, �鶹��Ʒ S� says Amanda Walden, senior lecturer of global health management and informatics. “The problem with the software is that you have to be sponsored by a facility to get training in it, and unfortunately, they do not offer educational versions of the software for our students to learn on. Having Epic training is a really big employment opportunity for our students. �鶹��Ʒ S�

To help bridge this learning gap, faculty met with Orlando Health to discuss their training needs, and learn what the organization would find helpful for potential employees to know. Through this, Orlando Health built training modules for the health administration students.

�鶹��Ʒ S�Students aren �鶹��Ʒ S�t able to touch any real electronic health records hands-on, but Orlando Health has created some simulated environments for them with interactive screens for them to click on that look like you’re actually in the electronic health record, �鶹��Ʒ S� Walden says. �鶹��Ʒ S�We started with the bachelor’s in health informatics and information management program, and they created five different training programs for us. �鶹��Ʒ S�

Students are also getting to learn some of the real tasks that employees need to do and why before simulating those tasks, Walden says.

�鶹��Ʒ S�Epic is the backbone; it does much more than just health records, �鶹��Ʒ S� she says. �鶹��Ʒ S�It is not just the doctor’s notes. It includes X-rays, labs and financial data. It communicates with other electronic health record systems, and it communicates with insurance companies and to government oversight bodies for reportin requirements, so students are really learning how to utilize the system as they would in the workplace. �鶹��Ʒ S�

Walden says the school is looking forward to continuing this partnership with Orlando Health, which is providing an invaluable experience for students.

�鶹��Ʒ S�The response from students so far was very positive, �鶹��Ʒ S� Walden says. �鶹��Ʒ S�They felt it was beneficial. The first class to try it out was last spring, and they really enjoyed them. Even if they weren’t able to complete all the trainings during the class, they asked for the opportunity to go back in and do them later because they knew and saw the value of being able to have this skillset. �鶹��Ʒ S�

She added that the program’s advisory board, made up of industry professionals, was also excited about the opportunity and the benefits it provides.

�鶹��Ʒ S�Together, Orlando Health and UCF bridge knowledge and care, [driving] healthcare innovation and advancing medical informatics for a brighter future, �鶹��Ʒ S� according to a statement from Orlando Health IT/CE learning leadership. �鶹��Ʒ S�By collaborating and partnering for progress in medical informatics, we are proud to design custom training based on the needs of UCF students. �鶹��Ʒ S�

Hou, a professor of in the College of Community Innovation and Education, has been named the 2024-25 Fulbright-Saastamoinen Foundation Distinguished Chair in Health Sciences.

The U.S. Fulbright Program partners with universities worldwide, inviting leading scholars to study and teach abroad in short-term appointments. The Distinguished Chairs Program is one of its most prestigious awards. Candidates are typically senior scholars with significant publication and teaching records.

On her upcoming trip, Hou will visit the University of Eastern Finland to work on the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability project, also known as the FINGERS study. This study shows that five lifestyle changes �鶹��Ʒ S� nutrition, exercise, mental stimulation, social activities and cardiovascular risk management �鶹��Ʒ S� can protect and promote brain health and slow cognitive decline.

Building on insights from the original trial, Hou will help the FINGERS research team explore the effects of digitally enhanced lifestyle interventions.

�鶹��Ʒ S�Researchers have found that these lifestyle changes are linked to better thinking and problem-solving abilities, �鶹��Ʒ S� Hou says. �鶹��Ʒ S�They emphasize the importance of sticking to these changes for lasting benefits.

With ongoing concerns about global aging and increased digital communication post-pandemic, we need new trial designs based on the successful FINGERS model. Although the original study was very successful, transitioning these lifestyle interventions to a digital format presents new challenges. �鶹��Ʒ S�

One of these new trials will study the correlation between hearing impairment and cognitive decline. Hou will evaluate the digital self-assessment tool using mixed-methods research, her area of expertise.

�鶹��Ʒ S�We don �鶹��Ʒ S�t typically link hearing impairment with mental decline, but the team is trying to study how personalized hearing rehabilitation may impact the cognitive function so we can better understand how older adults use digital tools, �鶹��Ʒ S� she says.

This study is a natural extension of Hou �鶹��Ʒ S�s research on aging in community, which focuses on helping older adults live independently while fostering connections with their communities to improve their well-being. Hou has presented her research at numerous universities overseas through hundreds of presentations, workshops and seminars.

She also has previous experience as a Fulbright Specialist. In December 2022 she traveled to Ben-Gurion University in Israel, where she studied local aging-in-community models and led mixed-methods research workshops at the Israeli Center for Qualitative Research.

Hou says she is fascinated by different countries �鶹��Ʒ S� perspectives on aging-in-community.

�鶹��Ʒ S�The differences [in traditions] have always stood out to me whenever I �鶹��Ʒ S�ve traveled or collaborated with colleagues around the world, �鶹��Ʒ S� she says. �鶹��Ʒ S�I �鶹��Ʒ S�m really excited to see how Finland �鶹��Ʒ S�s perspective contributes to healthy aging-in-community. �鶹��Ʒ S�

Hou will complete her appointment in Finland over two one-month visits �鶹��Ʒ S� the first in late August 2024 and the second in May 2026.

She says she is thrilled to help the FINGERS team bring worldwide attention to brain health and believes this experience will lead to many positive developments.

�鶹��Ʒ S�I foresee more opportunities through this Fulbright Distinguished Chair program, which I �鶹��Ʒ S�m really honored and grateful to be part of, �鶹��Ʒ S� she says.

The 18-year-old has an impressive academic resume for her age. At 17, she graduated from high school and Daytona State College at the same time, receiving both her high-school diploma and an associate degree thanks to dual enrollment and online homeschooling. There �鶹��Ʒ S�s also the fact that she skipped seventh grade, allowing her to finish high school early.

Next, Costanza plans to pursue her master’s degree in biomedical sciences with the goal of continuing on to medical school to achieve her ultimate goal of becoming a medical doctor by 25.

Constanza keeps busy outside of class, as well. She runs her own nonprofit to assist with the homeless youth crisis, and she competed for Miss Florida Teen earlier this year after securing the title of Miss Port Orange Teen. She also served as president of UCF �鶹��Ʒ S�s Golden Key International Honor Society and participated in UCF �鶹��Ʒ S�s Honors Undergraduate Thesis program through the Burnett Honors College.

�鶹��Ʒ S�I feel a sense of empowerment having accomplished so much, �鶹��Ʒ S� she says. �鶹��Ʒ S�Being Miss Port Orange Teen, I want to empower young girls to work hard and fight for their goals, and to never let anything stand in their way. That �鶹��Ʒ S�s been my goal for my own life �鶹��Ʒ S� to just keep going and graduate and become a medical doctor. It has been a little challenging, but I �鶹��Ʒ S�ve persevered. �鶹��Ʒ S�

Part of her goal to help others involved creating her nonprofit, the Enough is Enough Foundation, which guided her undergraduate thesis, through the creation of a resource guide to help homeless youth find access to food, shelter, clothing and healthcare in her community.

“It’s just so sad to see the statistics of youth who are homeless, so I want to really help my community and the entire state of Florida with eliminating youth homelessness in any way possible, �鶹��Ʒ S� she says.

Above all else, Costanza says she continues to challenge herself because she wants to inspire and help others �鶹��Ʒ S� including other Knights as she has always had a connection to UCF and wanted to go here.

�鶹��Ʒ S�My parents are alumni, �鶹��Ʒ S� she says, �鶹��Ʒ S�The main reason was I wanted to follow in their footsteps. I �鶹��Ʒ S�ve heard a lot of UCF stories, and I also knew it was a great school. �鶹��Ʒ S�

Despite being a young graduate, Costanza says she never felt out of place.

�鶹��Ʒ S�I honestly always felt welcome, �鶹��Ʒ S� Costanza says. �鶹��Ʒ S�I completed my associate degree online as well through Daytona State College, and in high school I was online as well, so I was used to the online system. �鶹��Ʒ S�

While she completed her degree fully online, Costanza �鶹��Ʒ S�s involvement outside of the classroom helped her feel connected to UCF and make friends. She visited campus to host Golden Key events and joined in for some homecoming activities like attending the homecoming football game.

She is considering switching to an in-person modality wherever she decides to go for her master �鶹��Ʒ S�s degree �鶹��Ʒ S� potentially here at UCF, although she hasn �鶹��Ʒ S�t yet decided where she will pursue her future degrees.

�鶹��Ʒ S�I’m so excited to graduate and walk on the UCF stage, �鶹��Ʒ S� she says. �鶹��Ʒ S�It’s just so awesome to think I’m only 18, and I’m going to have my bachelor’s degree. There’s going to be a lot of emotions, I’m sure, especially for my parents. �鶹��Ʒ S�

From taking action to help eradicate youth homelessness to her education in healthcare administration, Costanza �鶹��Ʒ S�s impending graduation brings her one step closer to achieving her dream of becoming a medical doctor. She hopes her story will inspire other UCF students to be persistent in achieving their goals.

�鶹��Ʒ S�Never let anything stop you, �鶹��Ʒ S� Costanza says. �鶹��Ʒ S�Always pursue your dreams, your passions and your goals, and knock down any [challenges]. Don’t let anything … limit you. �鶹��Ʒ S�

Vu, who teaches in the College of Community Innovation and Education‘s , was recently accepted to the two-year Dental Public Health residency program at the CDC. Dental public health is one of the 12 dental specialties recognized by American Dental Association. Through this advanced training program through the CDC, Vu is getting a head start on becoming board-certified in that specialty.

The CDC program is a combination of residency and fellowship, and Vu will gain more experience and learn skills across all ten designated competency areas of dental public health. This program has a strong focus on health management, health outcomes surveillance and health policy for oral health. He will have access to world-class experts in dentistry and public health, as well as CDC resources like the most current data and connections with other institutes like the National Institutes of Health. It is the oldest federal dental health residency program �鶹��Ʒ S� and very selective, as Vu is one of only two fellows selected this year.

Vu will receive approximately $35,000 in annual funding to complete the program part time over the course of the two years. The hybrid program allows him to complete most of his work from home, but the CDC will provide travel to conferences and in-person events a few times a year.

�鶹��Ʒ S�I �鶹��Ʒ S�m very excited and proud to get this fellowship, �鶹��Ʒ S� Vu says. �鶹��Ʒ S�The program is extremely competitive, and the people who apply for this program are not only in the United States but also from around the world. This will advance my career in health management, health policy and informatics. This fellowship is not about money for me; it’s about the trainings, networking opportunities and advantages when I apply for grants in the future. �鶹��Ʒ S�

Upon completion of the program, Vu hopes to obtain board certification in dental public health and become a diplomat in the field. The fellows take the first part of the exam before completion of the program.

�鶹��Ʒ S�The opportunity to train with the CDC is very prestigious, �鶹��Ʒ S� Vu says. �鶹��Ʒ S�The faculty are extremely supportive. They check on you every week to make sure that you have whatever you need for your success in the program. �鶹��Ʒ S�

However, a new University of Central Florida study recently published in Health Affairs shows that one of the most effective medications for treating opioid addiction is one of the least covered by insurance plans often used by patients with substance use disorder.

Researchers found that although most plans covered the immediate-release sublingual form of buprenorphine, extended-release buprenorphine injections were covered by less than half of commercial plans and less than a fifth of Medicare Advantage Plans. Furthermore, while most Medicaid plans did cover it, more than a third presented a barrier by requiring prior authorization before prescription.

The study �鶹��Ʒ S�s lead author, , says her key passion in research is trying to understand how to expand access to these life-saving treatments.

“Approximately 20% of people actually use buprenorphine or another similar medication called methadone for treatment of opioid-use disorder, �鶹��Ʒ S� she says. �鶹��Ʒ S�Most people don’t get any treatment, or if they do get treatment, they’re getting something that’s less effective. Unfortunately, there have been a lot of barriers to accessing it, and some of those have been either lack of insurance coverage or various prior-authorization requirements. �鶹��Ʒ S�

Buprenorphine can be prescribed by any clinician licensed by the Drug Enforcement Administration and comes in two overall forms: an oral immediate release version that is taken daily or a monthly extended-release intramuscular injection. Since some of the oral versions of the medication are available in generic form, they tend to be the cheaper option. The injection is newer and still under patent, making it the more expensive option.

How the Research Was Performed

Andraka-Christou, an associate professor in the at UCF, teamed up with Thuy Nguyen from the University of Michigan, W. David Bradford from the University of Georgia and Kosali Simon from Indiana University to examine Medicaid, Medicare Advantage and commercial insurance formulary files to compare insurance-imposed restrictions for buprenorphine from 2017-21.

They studied factors like insurance coverage, prior-authorization requirements, and other potential access barriers like step therapy and quantitative limits across commercial providers, Medicaid, and Medicare.

�鶹��Ʒ S�Medicaid covers about a third of people in the U.S. with opioid-use disorder and Medicare covers both the elderly and disabled populations, �鶹��Ʒ S� she says. �鶹��Ʒ S�That �鶹��Ʒ S�s important because among older Americans, the rates of opioid overdoses have also been increasing. Because people flow in and out of different types of insurance, it �鶹��Ʒ S�s very important to look at all insurance sectors. �鶹��Ʒ S�

What Andraka-Christou and her team found were stark differences in coverage and prior authorization barriers depending on the form of buprenorphine requested. Nearly all plans covered at least one form of immediate-release buprenorphine in 2021, and prior-authorization requirements and quantity limits gradually decreased for immediate-release buprenorphine.

The intramuscular, extended-release injection was subject to the most variance by insurer type. Their research determined that Medicare and commercial insurance were less likely to cover the cost of the buprenorphine injection �鶹��Ʒ S� with only 46% of commercial plans and 19% of Medicare Advantage plans covering it �鶹��Ʒ S� as compared to Medicaid. On the other hand, most Medicaid plans covered the extended-release version in 2021, although 37% still required prior authorization.

Despite the oral version now being largely covered by insurers, Andraka-Christou says there is a downside in that it �鶹��Ʒ S�s easier for opioid-use disorder patients to relapse if they skip doses. With the monthly intramuscular injection, that is less likely to happen.

�鶹��Ʒ S�The reason prior-authorization requirements are a problem is that someone with an addiction may have a short window of time during which they’re willing to go and get treatment, �鶹��Ʒ S� Andraka-Christou says. �鶹��Ʒ S�From a public health standpoint, it �鶹��Ʒ S�s very important to not have prior-authorization requirements for these types of medicines. The injection is also very expensive because it’s still on patent, so those requirements probably exist to cut costs. However, if someone had to wait days for the injection and has an overdose in that timeframe, then it might be less costly to not require prior authorization. �鶹��Ʒ S�

The barriers related to the oral version of buprenorphine have been a topic of conversation in U.S. healthcare for a while, but Andraka-Christou �鶹��Ʒ S�s team found that prior-authorization requirements for oral versions are minimal today compared to 10 years ago. With this new finding, she urges researchers, advocates and policymakers to shift their attention to the intramuscular injection version and work on addressing those barriers.

�鶹��Ʒ S�I think providing access to life-saving treatment needs to be a priority for policymakers and community advocates, and that �鶹��Ʒ S�s where my passion comes from, �鶹��Ʒ S� Andraka-Christou says. �鶹��Ʒ S�The fact is that we have this ongoing, horrific crisis, but we also have tools like buprenorphine and methadone that could cut the risk of overdose deaths in half if they weren �鶹��Ʒ S�t so underused. State lawmakers could help lead this effort by requiring insurers to cover extended-release buprenorphine without prior authorization. �鶹��Ʒ S�

Researcher Credentials

Andraka-Christou received both her juris doctorate and doctorate in law and social science from Indiana University Bloomington. She joined UCF �鶹��Ʒ S�s School of Global Health Management and Informatics, part of UCF �鶹��Ʒ S�s , in 2017. Her areas of expertise include health services, health policy and substance-use disorder treatment. Much of her research on the evolving opioid epidemic is summarized in her book The Opioid Fix: America �鶹��Ʒ S�s Addiction Crisis and the Solution They Don �鶹��Ʒ S�t Want You to Have (Johns Hopkins University Press, 2020).

Fellow is the highest level of membership the society gives, and acknowledges continued excellence and dedication to the field of gerontology. Hou was one of 49 fellows named this year who will be recognized at the GSA �鶹��Ʒ S�s annual Scientific Meeting in November in Tampa, Florida.

�鶹��Ʒ S�I am truly grateful and humbled by this honor, �鶹��Ʒ S� she says �鶹��Ʒ S�and remain committed to making a meaningful impact in aging communities across the globe. �鶹��Ʒ S�

Hou is a faculty member at UCF �鶹��Ʒ S�s College of Community Innovation and Education and founding director of its School of Global Health Management and Informatics. A Fulbright specialist, she has been invited to conduct research training workshops at multiple universities overseas.

As a public health researcher, she has published papers on Aging-in-Community models that allow older people to age while staying in their communities, cancer screening disparities, global healthcare management and HIV behavioral research. She is an expert in mixed methods research, program evaluation and community based participatory research.

She says gerontological research is crucial for gaining insights into the unique needs of older adults �鶹��Ʒ S� especially as medical advances allow people to live longer.

�鶹��Ʒ S�This research helps inform evidence-based clinical and community practice, policies and interventions to promote healthy aging and enhance the quality of life for older adults, �鶹��Ʒ S� she says.

However, not seeing a doctor face-to-face brings its own challenges, such as an increased likelihood of missing a symptom of an illness which can lead to a misdiagnosis, or finding ways to perform tests, such as a blood pressure check, remotely.

That �鶹��Ʒ S�s why University of Central Florida researchers are working on a new U.S. National Science Foundation-funded project to improve patient outcomes in telehealth medicine by using artificial intelligence to improve healthcare training and diagnostic reasoning, so signs and symptoms are not missed during remote doctor visits.

Artificial intelligence could help, for example, doctors remember to check for signs that might be hard to see in a telehealth setting, such as a way a person walks or holds themselves.

For the study, the researchers will look at how to best implement AI and new technologies into telehealth by observing doctor and patient communication in telehealth settings. This includes tracking physicians �鶹��Ʒ S� and patients �鶹��Ʒ S� biophysical responses such as eye movement, heart rate, and verbal and nonverbal communication, as well as recording the accuracy of physician diagnoses and any disruptions in the diagnostic reasoning process.

The researchers will also work with physicians, psychologists, engineers, and industry leaders in artificial intelligence to make recommendations on what is possible in telehealth and what could be on the horizon, such as ways to remotely perform tests, such as blood pressure checks and more using AI-based immersive virtual environments.

The ultimate goal is to use evidence collected from the project to provide recommendations for improving diagnostic reasoning in telehealth and offer ways immersive virtual technologies could improve the process.

�鶹��Ʒ S�As technology advances in healthcare, it can facilitate ease of use, reduced travel time and more, �鶹��Ʒ S� says Roger Azevedo, the project �鶹��Ʒ S�s principal investigator and a professor in UCF �鶹��Ʒ S�s School of Modeling Simulation and Training. �鶹��Ʒ S�But there �鶹��Ʒ S�s also new problems that arise, including the potential for medical errors. �鶹��Ʒ S�

�鶹��Ʒ S�We want to use AI to enhance the patient experience, so they get the care they need, and improve the doctor �鶹��Ʒ S�s experience by facilitating diagnostic reasoning, �鶹��Ʒ S� he says.

The project �鶹��Ʒ S�s co-principal investigators are Varadraj Gurupur, an associate professor in UCF �鶹��Ʒ S�s School of Global Health Management and Informatics; Mark Neider, a professor in and the associate chair of UCF �鶹��Ʒ S�s Department of Psychology; Mindy Shoss, an associate professor in UCF �鶹��Ʒ S�s Department of Psychology; and Dario Torre, a professor of medicine and director of Programs Assessment in UCF �鶹��Ʒ S�s College of Medicine.

The project is scheduled to begin in January 2022.

Azevedo received his doctorate in educational psychology from McGill University and his postdoctoral training in cognitive psychology at Carnegie Mellon University. He received his master �鶹��Ʒ S�s in educational technology and bachelor �鶹��Ʒ S�s in psychology from Concordia University. Azevedo is the co-lead of UCF �鶹��Ʒ S�s Learning Sciences Cluster and the director of the Laboratory for the Study of Metacognition and Advanced Learning Technologies. He joined UCF in 2018.