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The Iowa Consumer Outcomes Measurement System (ICOMS) Walk-Through April 2, 2009

The Iowa Consumer Outcomes Measurement System (ICOMS) Walk-Through April 2, 2009. About Telesage, Inc. www.Telesage.com. Over $4.5 Million in NIH Grants Since 1998. Automated Telephone Technology for Mental Health Self-Report ASI Via Phone and Internet

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The Iowa Consumer Outcomes Measurement System (ICOMS) Walk-Through April 2, 2009

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  1. The Iowa Consumer Outcomes Measurement System (ICOMS) Walk-Through April 2, 2009

  2. About Telesage, Inc.www.Telesage.com

  3. Over $4.5 Million in NIH Grants Since 1998 • Automated Telephone Technology for Mental Health • Self-Report ASI Via Phone and Internet • Self-Report Teen-ASI Via Phone and Internet • Application of IRT to Mental Health Outcomes Tracking • Enhancement of IRT Domains for State Instruments • Software for Internet and PC SCID Administration • Depression Screener for Perinatal Women

  4. Examples of TeleSage’s Experience in State Outcomes Tracking • Washington • Tennessee • Iowa • Pennsylvania • Louisiana (Pending)

  5. Complete Security Data Recovery • Mirrored RAID array drives • Encrypted nightly backups to secure off-site locations Data Security • HIPAA Compliant • 21-CFR Part 11 Compliant

  6. About the Iowa Consumer Outcomes Measurement System (ICOMS)

  7. What is ICOMS? • The Iowa Consumer Outcomes Measurement System is a data gathering and analysis system that Iowa providers will use to collect self-report outcomes data and obtain consumer progress reports. • It is sponsored by Iowa MHDS, and has been developed jointly with TeleSage, Inc. TeleSage has experience developing outcomes tracking systems in Washington, Tennessee, and Pennsylvania using instruments that are compliant with SAMHSA’s NOMs.

  8. What are Consumer Outcomes? • Consumer outcomes are indicators of quality of lifethat measure domains, such as symptom severity and social functioning, as well as recovery. • Outcomes must by definition measure change over time, so taking the survey at regular intervals is necessary.

  9. What are the Benefits of Outcomes Tracking? • Consumer: Empowerment in recovery process; treatment planning with clinician • Clinician: Identify consumer strengths and areas to work on in treatment; monitor changes over time • Provider: Quality improvement; meet requirements of certification, accreditation and/or payor organizations • Iowa MHDS: planning and quality improvement; identify best practices • State: planning and quality improvement; develop best practices and state benchmarks; demonstrate accountability for resources

  10. Guiding Principles • Minimal burden on consumers and providers • User-friendly technology • No dedicated hardware or additional software needed onsite • Actionable reports for clinicians and providers • Flexibility and ability to incorporate feedback from stakeholders

  11. The ICOMS Instrument Telesage, Inc. has been the recipient of several NIH grants to develop state-of-the-art outcomes tracking instruments for mental health consumers. The ICOMS adult mental health instrument will be introduced first, with instruments for youth mental health consumers and their caregivers to follow. Estimated Consumer Completion Time: 6-12 minutes Adult Survey - Total: 51 items

  12. Depression Anxiety Hostility Psychoticism Physical Impairment Social Functioning (Peer) Social Functioning (Spouse) Social Functioning (Family) Recovery Core Functioning Medication Compliance Medication Side Effects Substance Use Housing Transportation Safety Legal Work Functioning Service Utilization Survey DomainsAdult

  13. Design of Survey • The past seven days as time period • Five-point response scale (never, rarely, sometimes, often, always) • A single short sentence • One concept per question • 5th grade reading level (Cognitive interviewing conducted with SPMI clients for all items)

  14. Design of Survey (continued) • No contingent questions (if…, then…) • No lead phrases or internal punctuation • No abstract interpretations possible • No idiomatic language • No language that can be perceived as morally judgmental (Cognitive interviewing conducted with SPMI clients for all items)

  15. Sample ItemsAdult Survey

  16. Survey Intervals New Clients • Intake, +3 months, +6 months, +12 months, +18 months, +24 months, etc. Existing Clients* • Intake, +6 months, +12 months, +18 months, +24 months, etc. *Existing clients are those who have been receiving services at your agency for at least one month.

  17. Survey Domains (MHSIP) • Access, 7 items • Appropriateness/Quality, 11 items • Outcomes, 13 items • Prevention, 4 items *Total: 35 items

  18. Technology Options for Survey Administration Immediate Reports Phone/IVR PC Web/Touchscreen ODBCDatabase Paper/RDE Export in any format

  19. The ICOMS WebsiteHome Page

  20. The ICOMS WebsiteSecure Home

  21. ICOMS Clinician Report • ICOMS Clinician Reports are an informative and easy-to-read summary of a consumer’s survey(s). • They contain graphs and summary sentences of important questions, as well as the consumer’s actual survey responses. • They compare the consumer’s responses over time, displaying responses at three time points (intake plus the two most recent assessments). • Graphs display the consumer’s domain scores.

  22. Sample Clinician Report

  23. Description of Potential ICOMSAggregate Reports • Quarterly Reports • A snapshot of ICOMS activity for each provider available every three months; shows response rates, demographics, and intake scores for all consumers. • Longitudinal Reports • Two different types of longitudinal reports are available every six months for assessing cohorts (to show change over time for consumers who have taken a three and/or six month follow-up survey), one at three months after intake and one at six months after intake. • Cross-Sectional Reports • Available every six months; contains data on all consumers and compares consumers in the provider to consumers statewide.

  24. Sample Quarterly Report

  25. Sample Longitudinal Report

  26. Sample Cross-Sectional Report

  27. Data From Our Outcomes Tracking System in Tennessee (TOMS)

  28. Tennessee Adult Participation Existing consumers have been in treatment for at least one month.

  29. Medical Treatment (Adults)

  30. Intake to 3-Month Agency Cohort 1/1/2008 to 6/31/2008

  31. Intake to 3-Month Agency Cohort 2008 1/1/2008 to 6/31/2008

  32. Comparison of Change at Two Agencies Intake to 3-Month Agency Cohort 2008 1/1/2008 to 6/31/2008

  33. Comparison of Change at Two Agencies Intake to 3-Month Agency Cohort 2008 1/1/2008 to 6/31/2008 (cont.)

  34. Conclusions • Improve consumer-level care through clinician feedback • Conduct program evaluations/develop Evidence-Based Practices • Provide data to agencies and clinics for individualized QA purposes including accreditation • Fulfill NOMs reporting requirements • Assure block grant eligibility • Report data to legislature with budget request • Demonstrate return on investment • Monitor impact of policy changes on consumers over time

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