Computer systems in addiction treatment programs: Availability and implications for program evaluation Lori J. Ducharme * , Hannah K. Knudsen, Paul M. Roman Institute for Behavioral Research, 101 Barrow Hall, University of Georgia, Athens, GA 30602-2401, USA Abstract Addiction treatment programs have been slow to adopt computerized information systems. Little systematic data exist on programs’ technological infrastructures and use of electronic databases to store and analyze client information. Likewise, there is little information available on counselors’ access to and use of the Internet for learning about new treatment techniques. Drawing upon data obtained in 2002– 2003 from nationally-representative samples of publicly- and privately-funded addiction treatment centers and their counselors, this article describes the current state of the field in terms of data system availability and Internet usage. The availability of client-level databases is variable but continues to evolve. Programs maintaining electronic client data appear to be at an advantage for implementing outcomes monitoring activities. While counselors’ access to computers is high, their use of the Internet and the NIDA website is low. The implications of these findings, and directions for future research, are discussed. q 2005 Elsevier Ltd. All rights reserved. Keywords: Information technology; Client records; Computer systems; Internet use; Outcomes monitoring; Substance abuse treatment 1. Introduction Efforts to ‘bridge the gap’ between research and clinical practice in the addiction treatment field (Lamb, Greenlick, & McCarty, 1998) typically focus on the structural, economic, and philosophical barriers to the adoption of evidence-based treatment techniques by community-based treatment providers. Far less attention has been paid to the adoption of managerial and administrative innovations that may enhance an organization’s infrastructure. Such atten- tion is important for at least two reasons. First, the evolution of managerial or administrative practices is important to study within a broad focus on the diffusion of best practices in treatment organizations. Second, treatment programs’ technical infrastructure and their access to financial, staff, and knowledge resources play critical roles in facilitating or impeding the adoption of evidence-based treatment practices. Thus, diffusion studies must consider not only the innovation itself, but also the intra-organizational factors that may have practical implications and con- sequences for its adoption. The availability and influence of computer technology has been largely neglected by those studying the diffusion process. Among addiction treatment providers, computer technology is a distinctive innovation that has become prominent over the past decade. Electronic data systems support an organization’s billing, client tracking, and management decision-making activities. In addition to the direct impact that computerization may have on these program operations, indirect effects may be realized through access to the Internet, which facilitates dissemination as well as communicative interchange about innovations (Frambach & Schillewaert, 2002). Staff access to computer resources including the Internet may therefore bring access to new information resources that could influence the adoption of still other state-of-the-field practices. Historically a ‘low tech’ or ‘no tech’ sector of the health care industry, the addiction treatment field has been slow in its adoption of computerized information technology systems (Lamb et al., 1998). This lag is particularly notable in comparison to the broader field of health care delivery, which has been integrally involved in the adoption and continued development of computer technologies for patient medical records and billing transactions (Dick, Steen, & Detmer, 1997). Evaluation and Program Planning 28 (2005) 368–378 www.elsevier.com/locate/evalprogplan 0149-7189/$ - see front matter q 2005 Elsevier Ltd. All rights reserved. doi:10.1016/j.evalprogplan.2005.07.002 * Corresponding author. Tel.: C1 706 542 6090; fax: C1 706 542 6436. E-mail address: lorid@uga.edu (L.J. Ducharme).