1. Tennessee Outcomes Measurement System (TOMS) v.1.3
Tracking and Improving Behavioral Health Care
Throughout Tennessee

2. What is TOMS?
The Tennessee Outcomes Measurement System is a data gathering and analysis system that Tennessee providers will use to collect self-report outcomes data and obtain consumer progress reports.
It is sponsored by the state of Tennessee and the Tennessee Association of Mental Health Organizations (TAMHO), and has been developed jointly with TeleSage, Inc.

3. 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. 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
Agencies: Quality improvement; meet requirements of certification, accreditation and/or payor organizations
TAMHO: planning and quality improvement; identify best practices
State: planning and quality improvement; develop best practices and state benchmarks; demonstrate accountability for resources

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

6. Estimated Consumer Completion Parent/Guardian Survey
The TOMS Instruments
Estimated Consumer Completion
Time: 6-12 minutes
Adult Survey
Total: 51 items
Youth Survey
Total: 59 items
Parent/Guardian Survey
Total: 55 items

7. Survey Domains Adult 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

8. Survey Domains Youth and Parent/Guardian
Problem Severity
Internalizing
Externalizing
Delinquency
Hopefulness
Functioning
Inclusion in Mental Health Services
Medication
Legal
Service Utilization
School
Self-Harm
Housing
Substance Abuse
(youth only)

9. Sample Items Adult Survey
In the past 7 days …
Never
Rarely
Some- times
Often
Almost Always
1. I felt sad. 1 2 3 4 5
5. I felt nervous.
18. I heard voices when I was alone.

10. Survey Intervals New Clients
Intake, +3 months, +6 months, +12 months, +24 months, +36 months, etc.
Existing Clients* (phase in at patient review)
Intake, +12 months, +24 months, +36 months, etc.
*Existing clients are those who have been receiving services at your agency for at least one month.

11. Technology Options for Survey Administration
Immediate Reports
PHONE PC
WEB
ODBC Database
PAPER*
Export in any format
*Rapid Data Entry

12. The TOMS Website

13. The TOMS Website Features available as of March 15, 2007:
Adult, Youth and Parent/Guardian paper, online & phone surveys
Rapid Data Entry
Adult, Youth and Parent/Guardian clinic reports
Assessments Due page
Edit Clinician page
Preferences page
Help features such as detailed staff instructions, Frequently Asked Questions page, and video training modules

14. Paper Survey Administration

15. Phone Survey Administration

16. Online Survey Administration