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Telesage Outcomes Measurement System (TOMS) Tracking and Improving Behavioral Health Care Throughout Louisiana.

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Presentation on theme: "Telesage Outcomes Measurement System (TOMS) Tracking and Improving Behavioral Health Care Throughout Louisiana."— Presentation transcript:

1 Telesage Outcomes Measurement System (TOMS) Tracking and Improving Behavioral Health Care Throughout Louisiana

2 What is TOMS? The Telesage Outcomes Measurement System is a state-of-the art means for collecting and reporting client self-report outcomes and obtaining regular client treatment progress reports. TOMS is sponsored by the state of Louisiana Office of Mental Health (OMH), and has been developed jointly with TeleSage, Inc., based on experience in several other states implementing the system 2

3 What is TOMS? Specifically designed for public behavioral health populations Developed and used statewide in states of Tennessee, Iowa, Pennsylvania, & Washington Uses short items stated in simple language and at 5 th grade reading level Easy to understand 5-point response scale: Never, Rarely, Sometimes… 3

4 What are Consumer Outcomes? Consumer outcomes are indicators of quality of life that 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. 4

5 Who Benefits from Outcomes Tracking? Client Clinician Regions & LGE’s Office of Behavioral Health 5

6 What are the Benefits of Outcomes Tracking? For the Client  Contributes to a client-centered, recovery- oriented approach to treatment  TOMS self-assessment is from the client’s viewpoint  Gives the client a “voice” and empowerment in recovery process  Benefits client involvement in treatment with the clinician, contributing to outcome-focused care 6

7 Who Benefits from Outcomes Tracking? For the Clinician  Contributes to client-centered, outcome- focused treatment  Provides a comprehensive & concise view of clients functioning & needs at-a-glance  Provides standard measures of symptom severity, functional impairment, medication adherence and changes in these over time 7

8 What are the Benefits of Outcomes Tracking? For Regions/ LGE’s  Contributes to service quality improvement  Demonstrates accountability for resources  Helps to meet requirements for certification, accreditation and/or payor organizations For Office of Behavioral Health/ DHH  Contributes to program quality improvement  Demonstrate accountability for resources  Helps identify best practices 8

9 Guiding Principles of TOMS Development Minimal burden on clients and providers Actionable outcome reports for clinicians and agencies User-friendly and flexible administration technologies Web-based: Minimal hardware requirements or additional software needed onsite Telesage incorporates feedback from users contributing to ongoing system improvements 9

10 The TOMS Outcome Instruments 1-Adult (age 18+) Self-assessment  Total: 44 items 2-Youth (age 13-17) Self-assessment  Total: 53 items 3-Parent/Guardian (age 6-12) assessment  Total: 52 items Estimated Client Completion Time: 6-12 minutes 10

11 Self-assessment Domains - Adult - Depression Anxiety Anger Psychoticism Physical Impairment Social Functioning (Peer) Recovery Daily Functioning Medication Adherence Medication Side Effects Substance Use Emergency/Hospital Use Work Safety Legal Living Situation Transportation 11

12 Self-assessment Domains -Youth and Parent/Guardian- Depression Anxiety Anger Attention Deficit Hyperactivity Conduct Social Functioning (Peer) Social Functioning (Family) Empathy Daily Functioning Resiliency Medication Adherence Medication Side Effects Participation in Physical and Group Activities School Substance Use Emergency/Hospital Use Work Legal Living Situation 12

13 Self-assessment Intervals New Clients Intake Self-assessment (within 30 days of admission) Every 3 months thereafter Existing Clients* (phase in at client review) Intake Self-assessment (next treatment plan update) Every 3 months thereafter * Existing clients are those who have been receiving services at your clinic for at least one month. 13

14 TOUCHSCREEN PHONE (planned) ON-LINE (mouse) Immediate Reports Export in any format PC ODBC Database Technology Options for Self-assessment Administration *Rapid Data Entry 14 PAPER*

15 Touchscreen/ Online Survey Administration Consumer completes online self-assessment

16 Touchscreen/ Online TOMS Administration- w/ OMH-IIS Users Provider receives instant results

17 Touchscreen/Online TOMS Administration- No OMH-IIS Provider can receive instant results

18 Paper Survey Administration 18

19 Louisiana TOMS Home Page 19

20 TOMS Secure Clinic Site 20

21 TOMS Clinician Report TOMS Clinician Reports are an informative and easy-to-read summary of a client’s self- assessment(s). They contain graphs and summary sentences of important questions, as well as the client’s actual self- assessment responses. They compare the client’s self-assessment responses over time, displaying responses at four time points (intake plus the three most recent assessments). Graphs display the client’s domain scores. 21 *Intake = Initial/First self-assessment completed

22 Sample Adult Clinician Report 22

23 Sample Adult Clinician Report 23

24 24 Sample Adult Self-assessment

25 Other Telesage Instruments Client Quality-of-Care Surveys (C’est Bon and La Fete programs) Adult Survey (MHSIP-based)  Total: 42 items Parent/Guardian Survey (YSS-F)  Total: 32 items 25

26 Client Quality of Care Domains Access to Care Appropriateness/Quality of Care Outcomes of Care Treatment Involvement 26

27 TOMS Administration Process TOMS is completed at the point-of-service prior to a regular treatment session at the clinic TOMS is introduced by reception staff using the Client Information Sheet, which also accomplishes client informed consent The client is instructed on how to log-on and use the Touchscreen/On-line self-assessment via the TOMS Instruction Sheet When the client completes the self-assessment, TOMS automatically prepares the outcome report The TOMS is then ready for the next client 27

28 28 TOMS Implementation- Where we are now… TOMS Initial ImplementationTOMS Initial Implementation Started March, 2010 6 Initial Implementation Sites  Lafourche MHC  Terrebonne MHC  Lake Charles MHC  Shreveport MHC  Ruston MHC  Jonesboro MHC

29 29 TOMS Implementation- Where are we now

30 30 TOMS Implementation- Some Lessons Learned Importance of staff who will introduce & administer the TOMS Have someone nearby should client need assistance Make TOMS a routine part of everyday practice Administer prior to Service Session Offer option of Touchscreen or Mouse Begin with New Admissions- establish baseline

31 31 TOMS Help Ongoing Support  Thru weekly implementation GoToMeetings TOMS Website Technical Issues with the Site or Self- assessment  Contact TeleSage at

32 32 TOMS Help continued Other  Contact Annette Giroir at (225) 342-8641 or Or Randall Lemoine at (225) 342-8605 or

33 33 In conclusion… TOMS provides a state-of-the-art, easy-to- administer client outcome measurement system for monitoring and improving service outcomes at both the level of the individual client-clinician and the local/state administrative levels Q&A

34 34 Our TOMS is up!

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