Substance use disorder (SUD) patients present complexities often not appreciated in transitions of care. Here, we discuss the essential components of a continuity of care document (CCD) to improve care for this population. Drawing from subject matter experts in SUD, we iteratively designed and developed a CCD for use by clinicians to improve knowledge and care. Consistent with 42CFR part 2, a CCD was developed that included essential information for ED patients currently undergoing SUD evaluation and recovery services. The CCD included name and organizational identifiers, program status changes, program contact information, and referrals made for additional SUD services. The SUD CCD developed and tested in this study provided an example effort aimed at improving transitions of care for an often medically-complex and frequently non-compliant population. A CCD for ED consumption may be a useful strategy to support interoperable health information exchange in the care transition environment.

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