A pdf version of the FAQs can be found here.
What is ASAM CONTINUUM® and CO-Triage®?
ASAM CONTINUUM® provides counselors, clinicians and other treatment team members with a computer-guided, structured interview for assessing and caring for patients with addictive, substance-related and co-occurring conditions. The decision engine is based on The ASAM Criteria® and uses research-quality questions (including tools such as the ASI, CIWA, and CINA instruments) to generate a comprehensive patient report, that details DSM substance use disorder diagnoses, severity and imminent risks as well as a recommended level of care determination.
The ASAM Criteria® is the most widely used and comprehensive text of guidelines for treating patients with addiction. ASAM’s CONTINUUM® is a software which guides clinicians through an ASAM Criteria assessment and assists them with determining appropriate level of care placement. ASAM’s CONTINUUM and The ASAM Criteria should be used in tandem—the text provides background and guidance for proper use of the software, and the software enables comprehensive, standardized evaluation. With CONTINUUM, clinicians can easily conduct a comprehensive biopsychosocial patient risk and needs assessment along all six ASAM Criteria Dimensions while determining the ASAM Criteria Levels of Care recommendation.
ASAM CONTINUUM Triage (CO-Triage®) is a quick referral tool for alcohol and substance use problems. The CO-Triage questions help clinicians identify broad categories of treatment need along the six ASAM Criteria Dimensions. The decision logic in CO-Triage calculates the provisionally recommended ASAM Level of Care (1, 2, 3, 4 and Opioid Treatment Services) to which a patient should proceed to receive an ASAM CONTINUUM® Comprehensive Assessment – the definitive, research-validated, level of care placement recommendation.
CO-Triage can be administered either in person or over the phone in about 10 minutes. All questions captured in CO-Triage can be imported into an ASAM CONTINUUM Comprehensive Assessment. The pre-population of CO-Triage questions and the final report give receiving clinicians a preview of why the patient was provisionally referred to the particular treatment setting and can help speed up the comprehensive ASAM CONTINUUM assessment for definitive placement.
With CO-Triage, clinicians as well as other health care service providers can:
- Make provisional ASAM Level of Care treatment recommendations
- Easily identify ASAM dimensional needs that require immediate attention including any withdrawal management, co-occurring, or bio-medical enhanced services
- Increase the likelihood that patients are referred to the correct ASAM Level of Care
- Built from and easily synchronized with the research-validated ASAM Criteria comprehensive assessment tool
ASAM CONTINUUM® can be purchased directly thorough FEI Systems or through an authorized third-party distributor. ASAM is working with several health technology companies (typically companies that offer electronic health records systems) on a non-exclusive basis to offer ASAM’s CONTINUUM to the providers. A list of ASAM authorized CONTINUUM sellers is available on the sales tab of the CONTINUUM website.
Software Integration Details
FEi Systems also provides a streamlined stand-alone tool to access ASAM’s tools and can discuss this option further with interested customers.
Please review the Sales tab of the ASAM CONTINUUM® website to see a list of authorized distributors.
If CONTINUUM is not integrated with your EHR, please discuss your interest in CONTINUUM with your EHR representative. ASAM and FEi Systems can provide further technical and integration information to interested EHRs.
Please visit the Developer and Distributor page of the CONTINUUM website for more details.
The length of integration varies, based on the EHR technical department and degree of integration that is desired. In most cases integration can take up to 30 days.
Yes. FEi Systems provides a streamlined, stand-alone database to access ASAM’s tools and can discuss this option further with interested customers. Please contact FEi Systems for further information at firstname.lastname@example.org.
A full demo of the ASAM CONTINUUM® can be accessed by contacting email@example.com and requesting access to the demo video. Appearances may vary based on the EMR vendor and technological set up of the user.
If you’re accessing ASAM CONTINUUM® or CO-Triage® through your EMR vendor, contact them directly. If the issue cannot be resolved, it will be routed to FEi Systems. All other customers should contact FEi Systems directly at firstname.lastname@example.org .
Yes. Please refer to the developer and distributor section of the ASAM CONTINUUM® website.
ASAM is in the process of developing a continuum for use in adolescents. However, the ASAM CONTINUUM® is being used now by clinicians to assess treatment needs in adolescent populations. ASAM suggests that users conducting assessments with adolescents modify ASAM’s CONTINUUM using their clinical judgement, as some questions may be interpreted differently based on adolescent patient needs. The final reports from the ASAM CONTINUUM can also be interpreted as needed to be appropriate for adolescents. Changes made to your electronic health record platforms such as modifications to software functionality or assessment questions would be at the discretion of your current EHR company to provide other adolescent options as needed.
The ASAM CONTINUUUM® and CO-Triage® are computer-guided, structured-interview tools that assist clinicians and non-clinicians in conducting expert level biopsychosocial assessments. Clinicians for whom assessment is within the scope of their practice can conduct a CONTINUUM assessment. Non-clinicians, with training and supervision, can conduct a CO-Triage assessment. ASAM does not require specific credentials to use the tool when conducting assessments, however, states or other regulatory bodies may have specific requirements around who is considered qualified to conduct an assessment.
After training and a learning curve the CO-Triage® assessment typically takes about 10 minutes to complete.
After training and a learning curve of 15-20 cases, the ASAM CONTINUUM® assessment was independently found to take the average clinician about 60 minutes to complete. The first time an assessment is completed it might take two hours as users begin to navigate the tool. The assessment is designed to be easily broken up into separate sessions. Training in streamlining is important for efficiency.
Multiple controlled studies were conducted with the earlier versions of the ASAM Criteria Software on which ASAM’s CONTINUUM® is based. Several of these papers are found in Addiction Treatment Matching: Research Foundations of the American Society of Addiction Medicine (ASAM) Criteria, by D. R. Gastfriend, The Haworth Medical Press, Binghamton NY 2004. Alpha testing was done for three years in ten centers across Norway. Beta Testing was conducted in Milwaukee County in their Central Intake Centers. The National Demonstration Project tested the software for six months in real-world, routine clinical practice with twenty systems across the US.
The ASAM CONTINUUM® internally calculates the Addiction Severity Index (ASI) composite scores for all 7 subscales: Medical, Employment, Alcohol, Drug, Legal, Family/Social and Psychological. These scores, on a 0 – 1.000 scale, may be compared at one time-point vs. another to yield a change over time measure. EHR developers are given the instructions (API code) to access these ASI scores, so that the change scores can be calculated within the EHR for clients.
Research has demonstrated that when patients are matched to treatment with ASAM CONTINUUM®, they are more likely to engage in treatment. More than half of patients incorrectly matched to treatment dropped out, compared to about only a third of patients who were matched with the ASAM CONTINUUM.
Yes. The ASAM CONTINUUM® is designed for repeat assessment over time. Statistical information before vs. after treatment can be obtained from the DSM-5 diagnostic calculations, the Addiction Severity Index Sub-scale Composite Scores, and the withdrawal scores. More detailed views of pre- vs. post-treatment may be derived from individual items or groups of items, compared over time.
Nicotine Use Disorder, according to DSM-5, is a formal, diagnosable substance use disorder. ASAM therefore specifically calls for Nicotine Use Disorder to be treated – usually with a service intensity of Level 1 Withdrawal Management (L-1WM). (This recommendation is a clinical issue and is provided independent of reimbursement considerations or service availability. Of course, if the patient has other concurrent substance use disorder issues or mental health issues, then those will necessitate additional services or a more intensive level of care.)
CO-Triage® & ASAM’s CONTINUUM® do not specifically ask about homelessness as a state or report this, per se. Instead, the tools assess the functional impact of housing or homelessness on the patient’s risk for continued use or relapse. The ASAM Criteria 2013 edition specifies the importance of determining if the “living…environment is not supportive of good mental health functioning”, specifically, whether “the patient is unable to cope with continuing stresses caused by homelessness”. Thus, for example, one homeless patient who can find safe sleeping quarters & food (whether in a shelter or elsewhere) may tolerate Level 2 care, while another homeless person may clearly need Level 3 care. The mere state of homelessness alone is not prescriptive, however, as to the patient’s needs. Further details on homelessness and how it affects the patient should be entered into the Comment box at the end of the Family and Social History section. These comments will be printed in the Narrative Report print-out.
The ASAM CONTINUUM® specifically prompts the Interviewer to assess risks for sexual abuse in the course of the interview. As in any clinical assessment process, if further detail emerges, the
Interviewer is empowered to gather this information and it should be recorded in further depth in the Comments box at the end of the Family and Social History section. Gambling Disorder is not specifically assessed or diagnosed in the ASAM CONTINUUM or CO-Triage, as it does not directly participate in guiding Level of Care decision-making. Gambling behavior is, however, an important concern for some patients, and ASAM’s CONTINUUM does prompt the Interviewer to probe for any behaviors that may adversely impact readiness for recovery and risk for continued use or relapse to substance use. If such behaviors include gambling, the Interviewer is empowered to indicate this in the Comments box at the end of multiple sections. Appropriate places for gambling problem comments may include the Drug and Alcohol, Employment, Legal Information, Family and Social History, and/or Psychological sections. These comments will appear in the Narrative Report print-out.
There is an initial integration fee of $4000. This integration fee includes 25 hours of customer support from FEi Systems
The suggested retail price of CONTINUUM is $65.00 per end-user per month. Resellers of CONTINUUM® may charge up to $70.00 per end-user per month.
Yes. During the integration process, both tools are incorporated into the EMR platform, however subscriptions need to be purchased separately.
Yes, you are required to purchase a license. A purchase of 25 licenses or more comes with a discount.
ASAM CONTINUUM® can be purchased directly through FEI Systems or through an authorized third-party distributor.
ASAM is working with several health technology companies (typically companies that offer electronic health records systems) on a non-exclusive basis to offer ASAM’s CONTINUUM to the providers. A list of ASAM authorized CONTINUUM sellers is available on the sales tab of the CONTINUUM website.
Please visit the Knowledge Base to view a free walk-through of the ASAM CONTINUUM. If you have questions after viewing the walk-through, please contact ASAM CONTINUUMsupport@feisystems.com.
Yes, the ASAM CONTINUUM® and CO-triage® can be accessed through FEi Systems shared site. For more information, please contact ASAM CONTINUUM@feisystems.com
– Improved patient outcomes (30% better patient retention)
– Streamline and more easily secure revenue through care authorization
No, CO-Triage® requires a separate license.
Users can conduct an unlimited number of assessments once they have access to the ASAM CONTINUUM®.
The ASAM CONTINUUM® is being adapted for use in criminal justice populations and a fully implemented version is anticipated to launch by late 2020.
ASAM’s CONTINUUM® can reduce your staff’s utilization review burden, improve payment authorization, and save patient worry. Programs in the product beta test and demonstration project phases reported substantial numbers of hours saved per patient on prior authorization and utilization review—with both commercial and public payers.
Reports from the ASAM CONTINUUM assessments can be submitted for the utilization review process to indicate level of care recommended based on the ASAM-endorsed ASAM Criteria
assessment through ASAM’s CONTINUUM.
Other key ways that the ASAM CONTINUUM can assist with the billing and utilization review process are:
• Organizing all critical information for effective managed care evaluations
• Tracking progress of individuals as they move along the ASAM Criteria continuum of care
• Assessing effectiveness of treatment with quantitative outcomes
• Evaluating consistency of practice
• Identifying gaps in treatment
• Reporting on access to care issues and other needs in the health system
ASAM’s CONTINUUUM® and CO-Triage® are computer-guided, structured-interview tools that assist clinicians and non-clinicians in conducting expert level biopsychosocial assessments. Clinicians for whom assessment is within the scope of their practice can conduct a ASAM CONTINUUM assessment. Non-clinicians, with training and supervision, can conduct a CO-Triage assessment. ASAM does not require specific credentials to use the tool when conducting assessments, however, states or other regulatory bodies may have specific requirements around who is considered qualified to conduct an assessment.