Delivered by Dr. Paul Seale, Family Physician and Professor & Director of Research in the Dept. of Family Medicine Navicent Health/Mercer University, this presentation shows the potential Georgia has for being a leader implementing SBIRT.

1. Georgia: National Leader in
Training an SBIRT Workforce
J. Paul Seale, MD
Family Physician
Professor & Director of Research
Dept. of Family Medicine
Navicent Health/Mercer University
Macon, GA, USA

2. Healthy Habits Project 2002-3
 Macon Family Medicine clinic
 Clinicians trained: 25 residents, 8
faculty and 2 physician assistants (now
108 residents after 13 years)
 Screened 3,041 patients, 241 (8%)
positive screens, 115 (3.8%) received
BIs
 Demonstrated SBIRT’s feasibility
Seale, Shellenberger et al, Substance Abuse 2005; Seale, Shellenberger et al,
BMC Family Practice 2005

3. Project 2: GA-TX “Improving
Brief Intervention” Project
 Timeline: 2005-2007
 Aim: Replicate results of Healthy Habits
Project in 8 residency programs (4 in GA,
4 in TX)
 Engaged “early adopter” faculty to serve
as site coordinators: Rome (Floyd Medical
Center), Atlanta (Morehouse Family
Medicine), Albany (Phoebe Putney Family
Medicine), Savannah (Memorial Family
Medicine)

4. Dissemination Results
 189 residents & 6
faculty trained
 Broad geographic
distribution across
Georgia
Shellenberger, Seale et al, Academic Medicine 2009;
Seale, Velasquez et al, Substance Abuse 2012

5. Project 3: Georgia BASICS State
SBIRT Initiative 2008-2013
 Aim: Implement alcohol/drug SBIRT in
2 largest hospital systems in GA
 Partnered with state health dept, Grady
Health Systems, Emory & GA State U.
 Focused on SBIRT in emergency
departments
 New: “specialist model” of SBI delivery
 $15 million over 5 years
Johnson et al. Use of AUDIT-based measures, ACER 2013;
Johnson et al. Integration of screening question…Annals of Emerg Med 2013

6. SBIRT Grants by State, 2008
Missouri
W. Virginia
Georgia
Medical School Residency Grants

7. Project 4: Southeastern Consortium
for Substance Abuse Training
 Rationale: limited SBI/substance abuse
initiatives in the southeastern US
 Aim: Implement alcohol/drug SBIRT in
primary care residencies GA/NC/SC
 Recruited 4 Family Medicine, 3 Internal
Medicine residencies & PA program

8. Dissemination Results
 9 new clinics in 8 training programs,189
residents & 6 faculty trained in 3 states
 Added SBI training in new discipline:
Physician Assistant training program
 Training, systems intervention & strong
QI component led to increased SBI
rates in clinics
 Pioneering work on coding & billing
Seale, Johnson et al, Academic Medicine 2015; Le, Johnson et al, JGIM 2015

9. Project 5: SECSAT for Advanced
Practice Registered Nurses
 Rationale: as primary care delivery
changes to serve more patients, nurse
practitioners are in ideal role to do SBI
and bill for services provided
 Engaged 6 GA advanced practice
nursing programs (Mercer, Emory,
UNG, Armstrong Atlantic, GCSU, South
U.)
 Recruited 2 other “top ten” nursing
programs—Johns Hopkins, UAB

10. Dissemination Outcomes
 Training in 8 new nursing programs,
587 students, 74 faculty and preceptors
trained in initial 2 years (goal: 900)
 Creation of online training materials for
distance learners
 Very high level of interest, engagement
and ownership of this important
preventive practice
 Major efforts toward establishing
national SBIRT training standards

12. Newest Wave of SBIRT
Trainees (63 new US grants)
 Augusta University
 Medical students,
nurse practitioners,
residents in Family
Medicine and
psychiatry, &
psychology students
 Morehouse School
of Medicine
 Training students in
medicine, nursing
and social work

13. GA Workforce—Poised for
SBIRT Dissemination
 13 years of training projects
 >2,600 students/residents & 118 faculty
in medicine, nursing and PA programs
across Georgia & nearby states
 Follow-up interviews indicate these
trainees use SBI after graduation
 Opportunities to accelerate use of this
important preventive service by
“turning on” and funding SBIRT codes

14. Thanks!
Questions?
seale.paul@navicenthealth.org
(478) 633-5910