OneFifteen Using Science, Google-Backed Partnership to Tackle SUD

The nation’s substance use disorder (SUD) epidemic continues to climb to new heights, with opioid use disorder (OUD) proving especially hard to beat back. But in a region of the country that knows too well the toll of OUD, one treatment provider is stepping up in the fight through a partnership with one the world’s most influential companies.

Located in Dayton, Ohio, OneFifteen is a 4.5-acre campus consisting of residential treatment and housing, outpatient treatment and a crisis stabilization facility. OneFifteen also provides telehealth assistance, medication-assisted treatments (MATs) and places a significant emphasis on the science of addiction care.

Founded in 2019. OneFifteen is assisted through a partnership with Verily Life Sciences, a research organization that is a subsidiary of Alphabet (Nasdaq: GOOGL), the parent company of Google. OneFifteen is using its care approach — dubbed the “No Wrong Door” method — to provide much-needed help to residents throughout southwestern Ohio, which has been one of the hardest hit regions in the country with OUD.

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OneFifteen is specifically tasked with tackling the drug epidemic in Dayton, which at the time of the company’s founding had one of the highest overdose death rates in the country, largely stemming from opioids like fentanyl. Additionally, Montgomery County — of which Dayton is the county seat — has previously been given the infamous distinction as “the overdose capital of the nation,” as it recorded almost 400 overdose deaths in a six-month span shortly before OneFifteen opened its doors.

A nurse by training with a background in health care management, Marti Taylor is OneFifteen’s president and CEO, as well as Verily’s executive director of behavioral health. As the greater Dayton community and the nation struggles with OUD, Taylor believes strides can be made by employing data and research in the care delivery process — which she says is a hallmark of OneFifteen.

Behavioral Health Business caught up with Taylor, who talked about the mission of OneFifteen, which was recognized by Fast Company in its 2021 Innovation by Design Awards. She also discussed the company’s partnership with Google-backed Verily, how it has already surpassed expectations for the number of patients treated and its future plans beyond Dayton.

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You can read the conversation below, which has been edited for length and clarity.

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BHB: Talk about the mission of OneFifteen and what was the impetus for its creation.

Taylor: It really started in 2018. Verily was doing work in the behavioral health space at that time. It was their CEO who said: ‘“What are we doing with this opioid crisis that’s happening in this country? And shouldn’t we be leaning in a bit, as a health care tech company to help with this?”

Through lots of conversations and travels across the country, he said: “Let’s land this in Dayton, Ohio.” Dayton, unfortunately, was being named ground zero for the opioid epidemic. But also what we found in Dayton was a very collaborative community. Working with the [local] hospital association, working with two local health systems — Premier Health Network and Kettering Health Network — and working with public health agencies, there was lots of collaboration and leaning in on this problem.

Dayton felt like the place that we should go, and so our mission is simple, which is to really heal people experiencing substance use disorder through learning, science and partnership. Verily set the tone back when the original vision was laid out to say: “Let’s not recreate the wheel every time. Let’s figure out how we can partner with others and optimize the care that’s being delivered.”

How would you describe the partnership between OneFifteen and Verily?

Coming from academic medicine, where I’ve worked over the last 30 years, what’s been so great in having a tech partner is the user experience. When I think about Google, I think about the user experience. We have folks on our partner team at Verily who come to our campus at OneFifteen and talk about the user experience. They talk to our patients, they talk to our clinicians, and as we’re developing a new patient app, they say: “What’s going to work? What features would you like us to build into this app?” That’s been one of the things that has been exciting to watch, that we have this whole user experience team that is everyday thinking about the users in Dayton, and what’s going to be best for them.

None of us were necessarily planning this when we stood up OneFifteen as a startup company, but we wondered what it would mean if we needed in-person care to become more like virtual care. By having a partner like Verily developing our technology, and helping us pivot during the pandemic to more virtual care, they built that out in about nine days for us.

From a user experience standpoint, we were able to say: “It needs to be secure, but it needs to be simple for our patients and for our clinicians to use.” To date, we’ve had almost 10,000 visits, which may be that one patient has five encounters with us via telehealth, but they have 10,000 visits via telehealth.

We have a team of biostatisticians and data scientists who once we pull the data in, then they’re able to take that data and start to analyze it and say: “Here’s what we’re learning from the data, and here’s what changes we should implement to make our care even better.” Verily provides technology and data analytics, and are great partners to have working alongside us.

There are a variety of treatment providers that have set up locations in southwestern Ohio, which has been especially hit hard by SUD. In your opinion, how does OneFifteen stand apart from those other providers?

I like to think of the uniqueness of OneFifteen in four buckets. One, we focus on whole patient care. Secondly, we embrace a harm reduction model. Third, we are driving addiction treatment into the future. And the fourth bucket is in our continuum of care and having that entire care on one campus.

Whole patient care is our care coordination strategy. We have everything from psychiatrists, primary care physicians, peer specialists who have lived experience, care coordinators, nurse practitioners and a very multidisciplinary group of people. We really can focus broadly on the entire person, and not just their addiction treatment.

The second thing is harm reduction, which involves practical strategies and ideas to help reduce negative consequences associated with drug use. We have what we call a “No Wrong Door” approach. That means we’re going to meet people where they are. While we have a brick-and-mortar campus in Dayton on this five-acre campus, we’re also now putting telehealth hubs out in the community.

We have a telehealth hub in the public defender’s office, and we have telehealth hubs in emergency rooms as ways to really meet people where they are. Other practical things we’re doing around harm reduction is that we distribute Narcan, and we distribute fentanyl strips.

Unlike other programs, where patients may be terminated from care for using again, we see that recovery is very incremental, and we need to be walking with that person each step of the way.

The third thing is that we’re really wanting to drive addiction treatment into the future. We have a team of 15 people or so in South San Francisco, California [where Verily is located] who wake up every day saying: “What kind of technology should we be developing for Dayton to really help clinicians, as well as the patients?”

The fourth thing that is unique about our care is that we have the full spectrum of care on one campus. Every level of care is available, and that goes from outpatient care, to a crisis stabilization unit, to a detox unit, to what we call “living” — or which some people refer to as sober living.

OneFifteen has been around for less than two years, but it has already surpassed projections on the number of patients it expected to treat? What might you attribute that to?

The pandemic did have an impact on isolation. The pandemic was breeding isolation and social issues, and people lost their jobs. For many people, you lose something and you turn to alcohol or substances that you think are going to take away the pain. And we know that that’s not going to necessarily take away the pain.

We had set out in our first year to see 1,000 patients, and we are about 22 months in and we’re over 3,600 patients that we’ve now treated. It’s hard to say: ”Should we celebrate this number, or not?” But part of it for us, as far as why we’re seeing more patients and more of a demand than we thought, I’d go back to those four unique principles.

As SUD/OUD rates continue to rise, might OneFifteen look to expand its services to other parts of Ohio, as well as other regions of the country?

Our focus right now is still very much Montgomery County and the greater Miami Valley region. But certainly through the pandemic and through other opportunities that others have talked with us about, we’re in the very early stages of thinking about how we can better treat rural Ohio.

Dayton, while it’s not a big city, certainly is a more urban area than in many parts of Ohio. We’re starting to have conversations where we say: “How do we start to address some of these issues and meet people where they are, but specifically in rural Ohio?” That is probably the next expansion for us.

Do you think that analytics — be it on the addiction research side or the provider business side — needs to become more embedded into the daily operations of the SUD treatment sector?

We’ve got to get behavioral health to have the same level of parity that physical health has in this country. In a joking manner, people might think: “Gosh, if somebody has a cancer diagnosis, the neighbors are bringing casseroles over to the house.” Are people even talking about the fact that maybe their son is struggling with addiction? Certainly somebody is not bringing a casserole over and saying: “Well, let me help you out here with it.”

In every way that you look at the stigma that goes along with addiction care and behavioral health care, people don’t want to talk about it, because people think it’s a moral failing or something that they did wrong. There’s not a lot of people that really talk about addiction care as a chronic health condition. And so we feel strongly that we need to be shining the light on that. We need to be talking about that.

Payers will say to us: “I don’t have the data to know what I should be paying for and what I shouldn’t be paying for.” That’s where we feel we can come in with a strong partnership with a company like Verily to say, “Okay, we’re really going to hone in on the data and start to generate the evidence to say, this is what works, and this is what doesn’t work,” so that we can start to fix all of those other issues around payment reform and stigma.

Do you think that providers like OneFifteen represent the future of SUD treatment care nationwide?

I sure hope so, and I would point to those four bucket areas I talked about, where we see ourselves as being a little bit unique. But I think other providers have some of those similar traits as well.

When I look around and have conversations with other providers, they are so passionate about the care that they’re delivering every day. But because there are other parts of the systems that don’t work in their favor like payment, if they can’t somehow keep their doors open, they’re not going to be able to continue to provide substance use disorder treatment.

We need to continue to push to make sure that there’s always 24/7 access for individuals. That may not be for every provider, and some may just do Monday through Friday, 9-to-5 outpatient care that they can deliver. But we need to make sure that we’re thinking more broadly about access at a 24/7 level.

As we start to generate evidence, we want to make sure we’re sharing that with others. We’re not going to hold that in a OneFifteen silo, we’re going to share that evidence and say: “Here’s what works and what doesn’t work.” Working with many other providers, we want to try to have an impact on addiction care for generations to come.

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