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Policy on Induction Protocol Medication-Assisted Treatment Policy and Procedure Subject Number Date Issued Date Revised Date Effective Policy on Induction Protocol T0038_MAT 4-1-2016 4-1-2016 4-15-2016 Originated By: Approved By: Jonathan Ciampi David Kan, MD Purpose: The Policy on Induction Protocol outlines the two methods to be used during the induction phase when individual begin medication therapy using buprenorphine. Policy: Bright Heart Health physicians will determine if an office-based induction or at-home induction is appropriate for an individual. Procedure(s): 1. Physician will determine if an office-based or at-home induction is appropriate. a. Office-Based Induction

Policy on Induction Protocol Medication-Assisted Treatment ......Purpose: The Policy on Induction Protocol outlines the two methods to be used during the induction phase when individual

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Page 1: Policy on Induction Protocol Medication-Assisted Treatment ......Purpose: The Policy on Induction Protocol outlines the two methods to be used during the induction phase when individual

Policy on Induction Protocol Medication-Assisted Treatment

Policy and Procedure

Subject Number Date Issued

Date Revised Date Effective

Policy on Induction Protocol

T0038_MAT 4-1-2016 4-1-2016 4-15-2016

Originated By: Approved By:

Jonathan Ciampi David Kan, MD

Purpose: The Policy on Induction Protocol outlines the two methods to be used during the induction phase when individual begin medication therapy using buprenorphine. Policy: Bright Heart Health physicians will determine if an office-based induction or at-home induction is appropriate for an individual. Procedure(s):

1. Physician will determine if an office-based or at-home induction is appropriate. a. Office-Based Induction

Page 2: Policy on Induction Protocol Medication-Assisted Treatment ......Purpose: The Policy on Induction Protocol outlines the two methods to be used during the induction phase when individual
Page 3: Policy on Induction Protocol Medication-Assisted Treatment ......Purpose: The Policy on Induction Protocol outlines the two methods to be used during the induction phase when individual
Page 4: Policy on Induction Protocol Medication-Assisted Treatment ......Purpose: The Policy on Induction Protocol outlines the two methods to be used during the induction phase when individual

b. In-Home Induction i. Physician will explain the induction process to patients.

ii. Physicians will provide patients the in-home induction sheet