Optimizing SUD Care Delivery With a Robust Substance Use Disorder EHR

On one side of town, a client struggling with a substance use disorder (SUD) receives time-limited treatment in a facility constrained by outdated, manual systems, increasing the likelihood of disengagement before recovery can stabilize.

On the other side, a similar client engages in a comprehensive intake process and a full-scale assessment that accounts for their physical, mental, and social conditions. Their provider records those insights in a substance use disorder EHR and uses those insights to create a personalized treatment plan in the electronic health record and refine it as the client’s needs change.

The difference between these two experiences?

The latter follows the “golden thread” — a connected approach to care that links assessment, treatment planning, and adjustments across a client’s entire care journey.

In substance use treatment, clinical expertise remains foundational to that journey. But it’s the systems that capture, connect, and operationalize that expertise over time that make the golden thread possible in practice.

Importantly, the “golden thread” isn’t just a conceptual ideal. It’s codified in clinical standards. The American Society of Addiction Medicine (ASAM) 4.0 provides the framework for delivering this level of coordinated, whole-person care.

What Is ASAM 4.0?

The fourth edition of the ASAM Criteria is considered the standard of guidance for delivering person-centered, longitudinal, and coordinated care for clients with substance use disorders. It offers detailed support for:

• Assessing a client’s holistic needs using a person-centered approach

• Aligning that assessment with the correct level of care

• Developing a treatment plan that takes the client’s physical, emotional, mental, and social wellbeing into account

• Reassessing and adjusting care across the continuum of care as client needs, risk, and functioning change

Together, these principles reinforce a shift that has been decades in the making: moving from episodic treatment models toward continuous, whole-person care supported by modern clinical systems.

Essentially, ASAM 4.0 advocates for three main decision-making steps:

1. Assess the client based on six dimensions, including the client’s medications, biomedical conditions, risks, and recovery environment

2. Evaluate risk and severity across the six ASAM dimensions to inform clinical judgement

3. Determine the appropriate level of care based on the assessment and risk score

ASAM level-of-care placement criteria range from level 0.5, which calls for outpatient recovery, to level 4, which calls for 24-hour medically managed inpatient care.

Why Generic EHRs Don’t Cut it in SUD Settings

Research consistently shows that whole-person, context-aware care, which is central to ASAM 4.0, is critical to understanding and addressing substance use disorders. This includes assessing a client’s living environment and social determinants of health, which, one study found, helps move beyond historically narrow, pathology-based approaches.

When delivered services don’t match the ASAM level-of-care placement criteria, however, clients can get lost in the system, receive more or less care than they need, or miss critical transitions needed to stay on track with treatment plans.

Aren’t EHRs designed to solve these issues?

Yes, but many aren’t built specifically for substance use disorder care delivery, and most don’t integrate ASAM 4.0 criteria directly into workflows. These generic EHRs often come with:

• Ineffective documentation tools that lead to disconnections between in-person sessions and long-term planning

• Manual workflows that slow what should be continuous care

• Fragmented systems that break the golden thread between assessment, planning, care delivery, and follow-up

In fact, research shows that lack of interoperability, poor-quality evidence base, and workflow integration issues are some of the leading causes of EHR adoption delays. Implementing ASAM level-of-care placement criteria depends on better systems — tech that can facilitate, not hinder, the golden thread.

Meeting ASAM Criteria With a Substance Use Disorder EHR

A recent study focused on opioid use disorders found that EHRs can improve the quality of substance use care delivery, but only when they have effective workflows, real-time data, and the ability to adapt to treatment changes.

Top-tier EHRs like Core Solutions’ Cx360 Enterprise and Cx360 Intelligence platforms offer those capabilities and more, including:

Embedded, ASAM-Aligned Assessments

With integrated ASAM 4.0 criteria, advanced EHRs such as Core’s allow providers to evaluate clients according to ASAM’s six dimensions directly in the system. The Cx360 Intelligence platform — an artificial intelligence (AI)-driven solution — connects streamlined documentation features with assessments and exams, enabling teams to easily access, analyze, and summarize notes that aid in clinical decision-making.

What’s more, SUD providers can save considerable time and resources by reducing duplicative manual entry and disconnected assessments. Instead, they can link ASAM-aligned clinical outcomes data to reporting dashboards for faster, more informed level-of-care decisions.

Connected Assessments and Treatment Plans

Meeting ASAM recommendations requires providers to use assessments to determine the appropriate course of treatment. But if there are delays or hurdles between those two steps, negative outcomes are more likely.

The right substance use disorder EHR enables providers to pull ASAM 4.0 assessment data directly into SUD treatment plans without manual re-entry. This integrated assessment-to-treatment pipeline empowers providers to not only save time, but also manage co-occurring conditions, deliver comprehensive care, and ensure they align treatment with ASAM level-of-care placement criteria.

Monitoring, Tracking, and Reassessing

ASAM is clear about one thing: care for clients with substance use disorders doesn’t stop when they leave the office. EHRs like Cx360 Intelligence enable continuous, long-term assessments to ensure SUD clients stay on track with treatment plans, and providers can make needed adjustments over time.

The Cx360 Enterprise and Intelligence platforms also offer tools backed by AI that track client progress against defined parameters and alert providers when clinical review or intervention may be required, enabling timely, person-centered care. The AI-powered Cx360 Intelligence EHR provides clinical validation, symptom tracking, and ongoing assessments to strengthen long-term treatment efficacy.

Automating the Golden Thread for Better Care and Lower Risk

ASAM 4.0 is a vital tool for determining the intensity of care a client needs, and when integrated into a substance use disorder EHR, like the Cx360 Intelligence platform, it becomes an anchor for assessment and clinical decision-making.

Cx360 Intelligence connects every stage of substance use care, from intake to evaluation to level-of-care decision-making and beyond, strengthening the golden thread across the client journey. The result: reduced clinical and operational risk, better client outcomes, and far greater efficiency than manual systems offer.

Core Solutions partners with SUD providers nationwide to advance clinical excellence. Reach out today for a demo of the Cx360 Intelligence EHR and see why it may be the modern solution your SUD clinic is looking for.

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