ASAM CONTINUUM Assessment Updates:

  • Corrected item numbering: Two questions in the Drug and Alcohol Other Substance Use section have been updated to correct the item numbering. Occupational activities has been updated to D.s.0210 and Family/Friends has been updated to D.s.0220.

Report Updates:

  • A patient ID field has been added to all reports: To provide more clarity, all generated reports now display a Patient ID field in the header.
  • Updated narrative report messaging for non-resolving cases: In order to assist with non-resolving cases, the language used to describe non-resolving cases has been updated to better reflect the reason the system could not determine an accurate level of care.
  • Update #1: This change improves alignment between the ASAM CONTINUUM algorithm and the 2013 ASAM Criteria textbook: CONTINUUM no longer considers a risk of harm from others in the formula for current risk as that can imply a need for hospitalization or extended residential placement. This change reduces the frequency of recommendations of Level 4 and Level 3.3.
  • Update #2: This change revises a measure of current risk of harm to self or others to improve level of care placement for patients with past psychiatric issues that are unlikely to recur. It reduces the frequency of recommendations for Levels 4, 3.5, and 3.3.
  • Update #3: This change improves the rate of DSM-5 SUD diagnoses by adding a DSM-5 diagnostic question pertaining to continued use despite physical/psychological problems.
  • Update #4: This change edits Dimension 1 decision rules to better specify psychiatric complications of stimulant use and improve the gradation sensitivity of symptom severity across levels of care. The result is less overuse of Levels 4 and 3.7.
  • Update #5: This change resolves an internal conflict in the Dimension 3 decision rules for Level 1 COE.
  • Update #6: This version alignment step simply updates the ASAM CONTINUUM algorithm’s Level 3.1 COC decision rules sequence from the ASAM PPC-2r Edition (2001) to match the subrule sequencing in the ASAM Criteria 3rd Edition (2013).
  • Update #7: This change adds nuance to Dimension 3 decision rules within Level 3.1 to avoid excluding patients with some psychological severity that manifests only with active substance use and/or does not distract from the recovery process. The result allows more patients to receive recommendations for Level 3.1 instead of Level 3.1coc.
  • Version 2.10.1 is a branch release for the current 2.10 version in production. ASAM CONTINUUM has been updated to accommodate interviews that occur via telephone or video Telehealth, and under circumstances where it is difficult to appropriately assess a patient’s medical status: i.e. withdrawal symptoms or medical care requirements. Several sections of the tool have been adjusted to accommodate this update, including General Information, Medical History, and the Drug and Alcohol sections. The Narrative and Summary Report have also been updated to reflect the data input in the assessment with these updates. With these updates, ASAM has released a guidance video demonstrating the changes you will see in the software. You can find the video on the ASAM CONTINUUM website through the link included here. The video link can also be accessed from the CONTINUUM home screen. On the bottom left hand corner of the CONTINUUM tool there is a button for “Update Notes.”

User Interface Updates:

  • Click the new little blue circle “i” info buttons: Interviewers asked for helpful hints – so these are now added to many ASAM CONTINUUM assessment questions. They provide further details and instructions to assist the user while administering the assessment. Interviewers should click these for help – for less guessing & more knowing – about interpretation of a question, how to solicit a more targeted response, and how answers might affect placement.
  • What’s been updated – now and in the past? Look on the left, blue Navigation Panel, and click the “Releases” tab to see Current and Previous Release Updates. Important: Users must review these Updates to take advantage of new features designed to streamline interviews and improve accuracy.
  • Print Errors Now Fixed in Reports: When printing from an ASAM CONTINUUM Assessment, some answers were not appearing on the reports. These are now present next to the question asked. Some answers previously ran off the page – these now “wrap” so the entire answer appears in the document. Some questions that did not come up during the assessment were appearing on the printed version. These questions will no longer appear on reports.
  • Microsoft Edge “Save” Function – Now Fixed: Previously, the assessment screen showed the “Last Saved” time as “invalid date”.  This now shows “Last Saved” followed by the time and date the assessment was last saved.

ASAM CONTINUUM Assessment Updates:

  • Transdermal Patch – New Option for Route of Administration: In the Drug & Alcohol Section, Heroin and Fentanyl Sub-section, users can now select “Transdermal Patch” as an option in the dropbox for the question, “How did you most often or most recently use heroin or fentanyl? (Indicate most serious route of use)”

Report Updates:

  • Narrative Biopsychosocial Report – Now with Page Numbers: Page numbers and total number of pages are now shown on the Narrative Report at the bottom right corner of each page.
  • Narrative Biopsychosocial Report – Better Wording: We’ve improved the grammar in the Employment section, Education, Training and Resources sub-section within the Employment section. If the patient answers “yes” to the questions, “Do you have a valid driver’s license” and “Do you have an automobile available for your use?” the statement will now read, “He/she has a valid driver’s license and access to a car which may help him/her in maintaining employment.”
  • Narrative Biopsychosocial Report – Patient Relationship Details Now Corrected: In Family/Social Section, Recovery Environment and Social Contacts sub-section, we have improved the text output for the question “Who is the person (or persons) with whom you have had contact during the past 4 months and who has been most important to you?” For example, if the patient responded with “sexual partner/spouse,” the report will now state, “{Patient name} reports that in the past 4 months she/he has had close relationships with her sexual partner/spouse.”
  • Summary Report Dimensional Analysis – Corrects Level 4, Biomed:  The Levels of Care chart no longer includes “Level 4, Biomed”, since Biomed is a service qualifier only for Level 3.

User Interface Updates:

  • Item Numbering Convention for ASAM CONTINUUM & Triage: A new number convention was added to allow interviewers to more easily identify specific questions (e.g., for supervision purposes, or for bug reporting) and for researchers to more easily identify items within the decision logic.
  • Assessment: Multiple Formatting Issues: Drug and Alcohol Section: Headers and dropdown responses in the Drug and Alcohol section now wrap, so they don’t appear to go offscreen or require horizonal scrolling when the user zooms in.
  • Save Button Visible on Every Screen: Save button is now always visible on every screen, rather than only appearing after a change has been made in the assessment.
  • Add Message Banner to ASAM CONTINUUM and CO-Triage Screens: A banner has been added to the top of the ASAM CONTINUUM and CO-Triage screens to communicate important messages to end users.
  • ASAM CONTINUUM: Make Auto-save Function for Assessments Transparent: ASAM CONTINUUM now automatically saves the assessment every 3 minutes or after each time the user navigates to a new section within the assessment. The last save time is now displayed at the bottom of the screen.
  • Incomplete Items More Clearly Identified: In addition to the completion percentage for each section in the side navigation, ASAM CONTINUUM & CO-Triage assessments will now identify incomplete required questions. The subsection header will be in red font, and the field itself will be highlighted red.

ASAM CONTINUUM Assessment Updates:

  • Add Question to Legal Section Asking About Illegal Activity in the Last 30 Days: The following question was added in order to streamline data entry in the Legal section: “Have you ever been arrested or charged for any reason?” (Includes misdemeanors, driving under the influence, and other major driving violations, e.g., reckless driving, speeding, no license, etc.)
  • Add Validation for Abstinence Question on Additional Addiction and Treatment Items Screen: Validation added in Additional Addiction and Treatment Items section to make sure that the response to the “when last used” question for a specified drug does not contradict the response to the abstinence question for the same drug.
  • Add Response to Living Arrangement Question: In the Family and Social History section, the following response option was added: “Alone with Child/Children” to the dropdown for “What are your usual living arrangements (past 3 years)?”
  • ASAM CONTINUUM: Capture User Who Submitted Assessment: Both ASAM CONTINUUM and CO-Triage now capture the user who submitted the assessment to determine if a different user initiated the assessment than the user who submitted the assessment. The information is not visible on screen but will be available for EHRs to pull back for reporting purposes.
  • Narrative Report: Spelling Error Fixed in ASAM Dimension 3 on Problem List: On the Narrative Report problem list, the word “community” is now spelled correctly for the psychological section interviewer rating question “Is the patient able to safely access the community for work, education, and other community resources?”
  • Item Text Changes: Updated question text to provide additional clarification to the interviewer to increase more accurate responses.
  • All CUAD Questions Now Required in CONTINUUM: All questions related to the Chemical Use, Abuse, and Dependence (CUAD) scale are now required in ASAM CONTINUUM, for more accurate DSM 5 diagnosis information.

Report Updates:

  • ASAM CONTINUUM Summary Report Dimensional Analysis Now Lists All the LOCs That Meet the Criteria: The summary text and ASAM dimensional analysis grid on the ASAM CONTINUUM Summary Report now list all Levels of Care and qualifiers that meet the criteria.
  • Add Response from Text Box (ASIm1a and 6a) to the Narrative Report: In the Medical History section, question label was updated from “Describe the medical problems indicated in the above categories” to “Please describe specifically.” Response to the question “Is the patient currently showing symptoms or signs of intoxication” was also added to the Narrative Report.
  • ASAM CONTINUUM and CO-Triage Reports: Time and Date Stamp: ASAM CONTINUUM and CO-Triage reports previously reflected the date and time in Eastern Time. The reports now reflect the user’s time zone.

Co-Triage Assessment Updates:

  • Incorrect Spelling of Possibly Located in Co-Triage Assessment: On the Co-Triage Dimension 6 – Recovery/Living Environment section, the word “possibly” is now spelled correctly in the response dropdown to the question “Do you have any problems walking or getting around that would make it difficult to attend treatment?”

Level of Care Recommendation Updates

Version 2.8 updates bring the ASAM CONTINUUM algorithm closer in line with the latest version of the ASAM Criteria textbook and improve the accuracy of recommendations for several levels of care, including:

  • Increases in OTS, Opioid Treatment Services by distinguishing between the following cases: patients who meet federal methadone regulations; patients who do not meet regulations but are candidates for other opioid treatment services; patients who need both OTS and another level of care; and patients who wish to continue or resume OTS
  • Increases in Level 3.1 outputs
  • Decreases in Level 4, Medically Managed Intensive Inpatient Services
  • Improvement in Level of Care specificity related to patient supervision and structure, cognitive function, OTS need, and acute psychiatric risk

Medical History Section Updates

  • Blood pressure and heart rate questions are no longer required to accommodate interviewers that are unable to capture blood pressure and/or heart rate measurements during administration of the assessment

ASAM CONTINUUM Assessment Updates

  • Added popup help for Question in Completion Section: In the Completion section, the question “Does the patient exhibit any symptoms that would be considered life-threatening AND are related to alcohol or drug use?” now provides a helpful pop-up to guide an evaluator to answer more accurately. The pop-up states: “Immediate and life-threatening symptoms will result in a direct transfer to a medical hospital. Please confirm your response with a qualified medical provider.”
  • Added Fentanyl to the Used Substances Screen: Interviewers asked that in the Drug and Alcohol Section of the assessment, Fentanyl should be added as an option to the Used Substances screen.
  • Added the ability to select multiple options to the first question in the Review section: In response to end user requests, in the Review Section of both CO-Triage and CONTINUUM, users now have the ability to select a primary category of final disposition, and then multiple additional categories of final disposition. This will allow users, for example, to select Level OTS-Opioid Treatment Service in combination with any other Level of Care.
  • Unanswered questions should now remain blank instead of defaulting to “No”: Previously, after an assessment was submitted, all unanswered questions were defaulted to “No” or “False” when the assessment was reviewed or printed. With this update and going forward, unanswered questions will remain unanswered upon review or printing.
  • Question sequence improved in the Family/ Social History Section: In the Family/ Social History section, after review, it was found that the questions should appear on the screen in a different order to best evaluate the patient. This has been corrected so there is a change to the sequence in which the questions appear.
  • Question Response items are differing in CONTINUUM vs Co-Triage: The responses in the review section have been synchronized between CONTINUUM and CO-Triage.

Report Updates

  • Narrative Report: Question with multiple answers needs has been revised for Narrative Report: The question “Has the patient responded to appropriate recent efforts by the prescriber to maintain does at therapeutic levels?” previously required the answer to be positive for all 7 relevant substances in order for this to appear on the problem list. This issue has been addressed so that if the answer is positive for one or more substances, the item will still be added to the problem list.
  • Narrative Report: Output Error in Recovery/Living Environment Section: In response to end user comments, the problem list was updated so that negative responses are not inappropriately reflected as potential problems.
  • Narrative Report: Answers with 0 or No are answered as “He/She does not remember or will not discuss…”: In response to end user requests, in the narrative report, questions left unanswered or answered with 0 will no longer be represented by the phrase: “”He/She does not remember or will not discuss…” Each related phrase has been customized to be more accurate for an unanswered or 0 response.

User Interface Updates

  • EULA screen is displaying “This site can’t be reached” when “I Agree” is clicked: New users will no longer receive an error message upon accepting the terms of the End User License Agreement.
  • The system scrolls the user back to the top of the screen upon clicking Save: Previously, users were redirected to the top of the current section of the assessment when they clicked the Save button. This update allows users to save and retain the same position in the assessment section.
  • Navigation requires multiple clicks to access a subsection: At the request of end users, the user interface has been updated to make navigation through sections and sub-sections easier, for a smoother process and a reduction of time needed to complete the assessments.
  • Comment boxes are now resized in Print document: Previously, when users printed the CONTINUUM or CO-Triage assessment, comments boxes were cut off or sized wrong so that the comment was not fully visible. At the suggestion of end users, with this update, the comment boxes have been expanded to show all content when printing.