1. ACORN Outcome Measures A Collaborative Outcomes Resource Network December 10, 2010 Shanti Rios: 541/342-8437, srios@c-f-d.orgsrios@c-f-d.org Kirsten Lowe: 541/242-2946, klowe@c-f-d.orgklowe@c-f-d.org

2. Getting Started- Staffing Needs Someone to communicate with ACORN and Agency Staff: Organization set up, including provider accounts Download, copy and distribute measurement forms Periodic review of data; make corrections as necessary Train staff on how to view online data Serve as main contact person for agency staff/supervisors and ACORN staff about participation with ACORN Someone to process the forms: Receive forms Fax them to ACORN File in individual service records

3. Identification Numbers Assign a contact person to work with ACORN Get organization ID: LaneCare has given contact information to ACORN for each agency. ACORN will be contacting each agency’s contact person to provide this information. Assign “site” IDs: This can be done to differentiate outcome information specific to various programs. Ex: “01: Adult”, “02: Child”, “03: ICTS”, etc. During initial account set up, ACORN will be asking for a site list. To later add/remove sites for your agency, email your assigned representative or Jeb Brown (jebbrown@clinical- informatics.com). He will email your agency’s contact person when the change has been completed.jebbrown@clinical- informatics.com

4. Identification Numbers (continued) Assign unduplicated, clinician IDs. During initial account set up, ACORN will be asking for a clinician/clinician ID list. Clinician ID could be the NPI number (though this may be a long number for a clinician to memorize and write on each form). To add new users/edit existing users: 1. Site administrator login to: https://www.cci-acorn.org/login.asp. 2. Go to the Admin dropdown box and select Add/Edit Users. 3. To edit or delete an existing user, click on the user link. This is where you can add and delete sites, change email address, etc. To delete a site, put an “x” in the box before the site. 4. To add a new user, click “Add New User” link. A new screen will open up in which to complete the process. Access level will have to be specified. ** Test log in once confirmation has been received from ACORN that account is active. **

5. Identification Numbers (continued) Access Level*: Level 3: has “a lot of power” and should be rarely used; used for staff such as site administrator, clinical supervisor and Director. Can see all information for the agency. Level 4: use for a site (program) supervisor level user; can see only certain program (i.e. Adult program clinical supervisor) Level 5: use for a clinician who works in one program Level 6: use for a clinician who works in multiple programs Note: You can only assign access levels greater than or equal to your own.

6. Client Identification Numbers Establish client ID assignment system How is the number assigned? These must be unduplicated. Can re-use the same number if a file closes and reopens, though the number should not be re-used for a different person. How is the number tracked? CFD’s are generated by a database and this information prints on monthly open record lists How is the client ID communicated to provider? Are there Clinician Assignment reports, Open Record reports?

7. Forms Print out applicable forms (registration, child, youth, adult, Spanish, etc.) from online toolkit https://www.cci-acorn.org/login.asp Copy forms and make available to people when they arrive (i.e. wall pockets in waiting rooms and/or therapy rooms containing forms in labeled folders.) Train clinicians/staff on instructing individuals where to look for forms, to fill them out prior to appointments, what to do if folder is empty, etc.

8. Pre-printed Forms Forms can be pre-printed with Org ID, Site ID, clinician ID, client ID if you so choose. If you have individuals complete the forms while they are waiting, pre-printed forms could be an issue.

9. How to Complete a Form See attached sample Train clinical staff on how to fill out form and where to submit it upon completion. Forms: Registration form upon intake/open (completed by clinician) Initial outcome form upon intake/open (completed by individual), with “01” in the session number field. You do not need to keep track of which session number after the initial registration. You can begin implementation with individuals after the first session; that session number would be put in this field. (more to come later). Subsequent forms prior to each session (completed by individual). Submit to central location to be faxed to ACORN.

10. Faxing of Forms Train administrative staff on where to fax forms. 800/961-1224 Maybe identify on the form after it’s been faxed to avoid duplicate faxing. Example: red dash mark on right corner, fax stamp, etc. File forms in service record for review in session.

11. Viewing Data Training of Clinicians: See attached handout for what CFD has given. Train clinicians on how to log in to https://www.cci-acorn.org/loginhttps://www.cci-acorn.org/login to view data for their open records. Train clinicians to whom within your agency to report “errors” in data. This person should then be responsible for following up with ACORN and making sure that the data is corrected. Training of Supervisors: Train supervisors on how to log in and view clinician/program data and how to use this data in supervision. Be prepared to answer questions such as, “What does this mean?” Click on terms such as “GDS” to have the definition pop up. Training of Administrative Staff Train ACORN data person how to download data, review it, correct errors, etc. (Work with person at ACORN on this.)

12. Frequently Asked Questions What is the best way to complete the form? For the most accurate and timely results make sure you: Ask the individual to fill out the appropriate ACORN form before each session. Ask individuals to fill in the circles with a PEN (pencil doesn’t fax well). Filling in the bubbles completely is best. “X”s work OK if they are neat. Check marks are the worst. If the software can't read the marks clearly, it brings up the form for human verification. They can usually process the form OK, it just takes more time to show up on your toolkit and increases the chance of error. You should print Clearly In Pen: Clinician ID, Client ID, Date, and Site (Program). Write like a robot, with clear numbers that don’t go in to the next box.

13. FAQ’s (continued) What if the individual has an ACORN ID, however I haven’t been administering the questionnaire? If there are people that you have seen several times without administering the ACORN questionnaire and you want to begin using it now, you will need to note the session number you first administer the form. For example if this is your 12th session, you would write “12” in the Session # box. Does the number of questionnaires in the “assessment count” include the registration sheet? No. How often should individuals be completing questionnaires? Ideally, they would complete a form before each session. The first session would be very important for establishing an accurate baseline.

14. FAQ’s (continued) What if the person chooses not to participate? Not a problem, though you may want to have some sort of “Opt Out” tracking system. How do I translate this data into service provision? For more detail on how you can use the data as related to outcomes, visit the ACORN homepage: www.psychoutcomes.org using your log in information. The site offers many links to descriptions and definitionswww.psychoutcomes.org Martin Waechter will be facilitating a discussion in the future for supervisors. What if an individual does not fill out the form completely ? Send it in. If there are enough items completed, it can still be scored by ACORN.

15. FAQ’s (continued) Who should complete the form? The Child (or Youth) or the Caregiver? This is your choice. Once you make the choice, it is important that you are consistent. Don’t switch between having the youth fill out the form, and then the caregiver at a later session. If it is decided that the caregiver will complete the forms and the caregiver is not present for a session, skip administering ACORN for that session. What age group are the Child/Caregiver forms for? Child is age 11 and under, though is person-specific and is a clinical judgment call. What age group are the Youth/Caregiver forms for? Youth is age 12 and older, though is person-specific and is a clinical judgment call.

16. “If I Could Do It All Over Again, I’d…” Roll in everyone at once, current and new. Check the copy quality of the forms. Best to not make copies from copies. The boxes in the corners should be solid squares. If the copy quality is poor, this increases the likelihood of ACORN needing to manually enter data (could increase error rate). Periodically check data for errors. “Train” individuals to complete the form prior to the session while waiting. Have the measures on the back of the session note (less filing).

17. More Friendly Advice It is a good idea to have someone review the forms when faxing them. A blue highlighter works well to dot the bubbles if they are not completed well. Figure out a method to regularly distribute ID numbers, including clinician, site and client IDs.

18. Contact Information Jeb Brown: Center for Clinical Informatics jebbrown@clinical-informatics.comjebbrown@clinical-informatics.com, 801/541-9720 CFD Contacts: Kimberly Miller: peer support for administrative staff: kmiller@c-f-d.org, 541/242-2937kmiller@c-f-d.org Martin Waechter: support re: supervisory use: martin@c-f-d.org martin@c-f-d.org