ASAM CONTINUUM Release Notes
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.
- 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.
- 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.