I am an MD living in the Montreal area where I did my trained in family medicine. Two and a half years ago I began work part-time at a community health centre treating people with opioid addiction and other substance use disorders in Ottawa, Canada. I have observed the dismal rates of relapse after rehab, and I now take a harm-reduction approach, where appropriate.

I read your web-synopsis of the virtual hospital idea and would like to know a bit more about it. Is this a pilot program or a clinical trial? I am no longer working at the Ottawa Hospital where my ReasearchGate account is linked, so my home email is best . Thanks! - Madeline O'Connor, M.D., CCFP

This is a pilot program launching in MA. I will be posting more info to RG but I would be happy to email further documentation on request. Our goal is to use the latest in information technology to support our clinicians in whatever approach they take to a particular patient - be it harm reduction (eg burprenorphine, etc) or abstinence-oriented. Our only view is that treatment decisions should be informed by aggregate outcome data (heretofore unavailable in granular form) and that Tx protocols should be specialized to individual patients. The Virtual Hospital is an attempt to make treatment of substance-use disorder highly data-driven, with most of the raw data deriving from patients' smartphones and accessories (eg vital signs Bluetooth watch) that allows clinicians (and supporting mental health workers) to monitor and communicate with patients 24x7 in their real-world environment at a fraction of the cost of residential treatment. We also provide office-based outpatient treatment triaged based on the health status of the patient.

I have been practicing in the addiction field for many years. One of my concerns is the "disconnect" between treatment in published studies (basis for evidence) and treatment effectiveness in the "real world" . Most of studies are short-term and university-based. Addiction treatment is long term and many patients receive care from physicians and clinicians with limited training/experience. Your work may answer many questions... including questions including how evidence-based treatment translates into outcomes in real work practice... Thanks for you work!

Hi - I am interested in this, but cannot access your website - can you send further details?

Robert, we have moved the website to www.predicticare.com, and my full time affiliation is now with PredictiCare, the non-profit arm of which runs the Virtual Hospital for Addiction using PredictiCare software.  I look forward to your comments.

Devin Hosea, PredictiCare, Inc, 760 Chapel St., New Haven, CT 06510 USA - +1 609 558 8808  [email protected]

www.predicticare.com