Table 2. SEIPS model, current state, and areas for improvement.

SEIPS DOMAINS	DEFINITIONS	CURRENT STATE	AREAS FOR IMPROVEMENT
ENVIRONMENT	Environment: the physical environment and location of the system	8 countries globally (U.S., UK, Australia, Canada, Austria, France, Ireland, Italy) Highly variable setting Primarily health centers affiliated with academic institutions	Expand primary care interventions to more community health settings
ORGANIZATION	Organization: includes concepts such as relationships between healthcare workers and patients as well as coordination, collaboration, and communication between those involved in the system	Existing Care Organization Models Coordinated Care: minimum 2–3 professions working to coordinate care to deliver best practices (e.g. NCM, Pharmacist & Physician) Multi-disciplinary Care: 2 disciplines working together (e.g. Psych & GIM) Shared Care: specialty services (e.g. addiction psychiatry) lead the induction process & hands off to Internal Medicine/Primary Care to share longitudinal care Chronic Care: utilizing healthcare resources to self-empower individual management of chronic disease Physician Centric: single physician (or group of only physicians) working with available resources to manage OUD with BP/Methadone/NX	Implement Coordinated Care models with non-physician team members (i.e. RNs) to help manage patient appointments and lab results Evaluate effectiveness of multidisciplinary teams in providing comprehensive behavioral counseling and better outcomes Determine appropriate skillset needed by non-physician team members to appropriately delegate tasks for high quality care
PERSON/TASKS	Person: all of the individuals, both healthcare workers and patients, involved in the design of the work system Tasks: clinical processes and responsibilities of both the healthcare workers involved in the system as well as responsibilities for the patient (i.e. receiving medication, counseling attendance, etc.)	Large variation in type of skilled professionals providing support (e.g. nurses, pharmacists, counselors) Pharmacists roles and tasks (i.e. supervising dispensing, clinical appointments, management) dependent upon intervention Behavioral health providers ranged in training (i.e. PhD psychologists, certified addiction counselors, social workers)	Capitalize on various providers’ skillsets to deliver high quality care Employ clinical pharmacists for complicated medication dosing and management Increase clinical support (i.e. nursing) responsibility in management of patients
PROCESS	Process: the flow of actions or steps taken to provide patient care (e.g. order of delivery for intake, induction, maintenance, and follow up)	Use of non-physician staff to conduct patient intakes decreased physician work load Home inductions allowed patient autonomy and less frequent initial appointments Limited studies evaluated behavioral counseling approaches compared to medical management	Understand which patients can safely undergo home inductions Streamline home induction process to decrease care utilization during induction time period Utilize non-physician team members to conduct patient intakes Develop technologies and systems providing after hour support for patient care, data collection, & feedback Promote PCP management of stabilized patients on maintenance medications within specialty addiction treatment programs
TECHNOLOGY & TOOLS	Technology and Tools: components of the system including various information technologies like electronic health records, human factors characteristics of technologies (i.e. usability), and other technologies incorporated	Only 10 studies explicitly noted using patient treatment agreement Most studies used some form of a urine drug screen to monitor adherence Only 3 studies used panel management structure to keep track of patient level data	Standardize important tools (i.e. toxicology screenings & management structures) to monitor patient and population level outcomes
PATIENT/ PROVIDER OUTCOMES	Patient Outcomes: participant perceptions of the care delivery model, retention rates in the intervention, and health outcomes for the participant Provider Outcomes: provider perceptions of the care delivery model and system	The most commonly measured patient outcomes were retention in intervention, self-reported abstinence, and abstinence via/urine toxicology screens Less than half of the studies collected outcomes regarding other common primary care based comorbidities Provider outcomes were only discussed in 10 included trials Provider outcomes did highlight the benefits of coordinated care models	Gather patient-centered outcomes including management of physical and mental comorbidities Collect outcomes related to social determinants, social support, and improvement in work/personal level functioning Collect provider outcomes regarding appropriate levels of training to provide care Develop and evaluate provider support systems to provide ongoing education and prevent provider burnout