3.1. What this study adds to our knowledge
Due to healthcare reforms (Affordable Care Act, parity law), highquality
integrated primary care (including home-based primary care)
is considered a key solution to improving care for individuals with
complex health conditions, including diabetes and SUDs [7,56–58].
SBIRT is considered a “primary care” approach to preventing substancerelated
problems and enhancing early intervention and utilization of
evidence-based treatment; effective use of SBIRT may improve coordinated
specialty care for SUDs and tracking outcomes [4,8,57]. Nevertheless,
empirical data from studies conducted in real-life settings are
needed to better understand the feasibility of implementing SBIRT and
its consequent clinical impact. Furthermore, EHR can be a crucial tool
not only for streamlining the SBIRT workflow through the use of EHRembedded
decision algorithms, but for facilitating its implementation
through health information sharing and documentation of clinical quality
measures [1,2]. EHR data also provide a practical research resource for developing
learning healthcare systems [58]. These shifting changes in
healthcare delivery require the development of an innovative research paradigm for behavioral healthcare and SUDs that is conducted in clinical
practices, taking into account patients' prior medical history and subsequent
healthcare use and outcomes.