Version 3.1.2 Release (September 28th 2020)

Version 3.1.2 updates ASAM CONTINUUM to improve consistency within the assessment and improve the Narrative and Summary Reports. Details regarding the release can be found below.

Bug Fixes within the Assessment:

  • The internal error checking previously checked “How long was your last period of voluntary abstinence…?” (ASd15) against “When was your last use of [substance]” (ASd##R). When the two response values were not equal, the system triggered a pop-up error message. This update now allows for the possibility that the patient may have stopped using involuntarily prior to the assessment (e.g., due to incarceration), so that there can be different values for ASd15 and ASd##R.

Narrative Report Bug Fixes:

  • Medical Section: On question ASm09, “How would you rate the patient’s need for medical treatment?”, when the interviewer selected “1” or “2” (“minimal health issues”), a logic error caused the Narrative Report to describe patients’ medical problems as “moderately severe” . This has been corrected.
  • Legal Section: The Narrative Report previously did not display all arrests/charges that were endorsed. This has been corrected for both standard and RISE versions of ASAM CONTINUUM.
  • Psychiatric Section: The “Serious Emotional and Psychological Problems – Lifetime” subsection of the Psychiatric Section incorrectly reported the history of depression and suicidal ideation for some patients. This was due to faulty sentence string logic, which has been corrected.
  • Numerous other minor language and reporting improvements have been made as well.

Summary Report Bug Fix:

  • Final Level of Care Recommendations Section: Recommendations for some Co-Occurring Enhanced Levels of Care previously stated that the patient “met the diagnostic criteria for a mental disorder.” Since ASAM CONTINUUM currently calculates DSM-5 diagnoses for substance use disorders but not other psychiatric disorders, this sentence has been deleted.

RISE-Only Fixes:

  • ASAM CONTINUUM RISE (i.e., the Re-entry Interview for patients leaving a controlled environment): The Narrative Report has undergone multiple changes to the time frame of assessment questions. For example, “How many close friends do you have?” is now asked in the future tense in RISE: “How many close friends will you have when you re-enter the community?”. A few other examples of the many specific changes include:
    • General Information Section: A CONTINUUM sentence stating how long the patient has lived at their current address has been rephrased in RISE to: “Before entering the controlled environment, [patient] had lived at [his/her/their] prior address for [time period].”
    • Employment and Support Section: A CONTINUUM statement of past 30-day income has been rephrased in RISE, e.g.: “In the past 30 days, [patient] has made [$] income. This includes work while in the controlled environment. In the first 30 days after re-entering the community, [patient] expects to be paid for working on [#] days.”
    • Employment and Support Section: A CONTINUUM statement as to whether the patient has a driver’s license is now rephrased for in RISE: “When [patient] re-enters the community, [he/she/they] will [have/not have] a valid driver’s license.”
    • Alcohol and Drug Section: CONTINUUM data such as past 30-day alcohol/drug use history are now rephrased in RISE, e.g., “[He/she/they] reports experiencing alcohol problems on [#] of the last 30 days during the time period when [he/she/they] most commonly used In the 30 days after [he/she/they] re-enter[s] the community, [he/she/they] expects to be [moderately/slightly/etc.] bothered by these problems.”

Previous Updates

ASAM is pleased to announce that Version 3.1 of the ASAM CONTINUUM and CO-Triage software will go live on Thursday, August 27th. Preliminary details regarding the upcoming release can be found below.

Important Clinical Updates in Version 3.1:

  • Updating: Revision of OTP (Opioid Treatment Program, i.e., federally licensed methadone maintenance programs) questions and decision logic to align with current federal OTP regulations
  • Streamlining: Removal of the “Opioids and a Controlled Environment” CONTINUUM section
  • Improved Consistency: Patients who qualify for OTP will also receive a Final Level of Care recommendation for OTS (Opioid Treatment Services, including OBOT)
  • Improved On-screen Tracking: The question numbering system has been revised throughout CONTINUUM and CO-Triage to improve intuitiveness and long-term utility.

Changes to the OTP and OTS assessment questions and decision logic include:

  • Removal of tolerance and withdrawal requirements: Current symptoms of tolerance and withdrawal are no longer required for OTP admission under federal regulations. Instead, the algorithm requires that a patient must have met DSM-5 criteria for opioid use disorder for at least one year prior to admission.
  • Exception for formerly incarcerated patients: The General Information section now asks whether the patient has been released from a penal institution in the past six months (rather than the past 14 days), or will soon be released; and the “Opioids and a Controlled Environment” section has been removed since tolerance and withdrawal symptoms are no longer required for OTP admission.
  • Exception for pregnant patients: Recent opioid use is no longer required for OTP admission. The decision logic has been updated to reflect current requirements of confirmed pregnancy and an active DSM-5 diagnosis of opioid use disorder.
  • Exception for previously treated patients: OTP readmissions no longer include the requirement that a patient must have previously been prescribed an opioid withdrawal protocol. Instead, patients can simply have received treatment from an OTP within the past two years. CONTINUUM’s decision logic has been updated to reflect this change.
  • The decision logic has also been updated to ensure that since OTP is a subset of Opioid Treatment Services, all patients who meet OTP will also receive a Final Level of Care recommendation for OTS.

Updates to the On-screen Numbering System:

Version 3.1 improves the on-screen numbering system throughout the assessment for questions in both CONTINUUM and CO-Triage. The new system will facilitate communication between assessment users and technical support staff even if the question sequence changes over time. It also will identify the source of questions whose content or format is drawn from other validated instruments (e.g., Addiction Severity Index, CIWA – Clinical Institute Withdrawal Assessment for Alcohol, CINA – Clinical Institute Narcotic Assessment).

ASAM has developed a guidance video to provide a detailed explanation of the changes you will see with this release.

Other recent guidance videos can also be found below.

CONTINUUM Re-Entry Interview Script Enhancement (RISE)

Version 3.1 makes further improvements to the RISE, for patients who are in a controlled environment and will soon re-enter the community:

  • Increased sensitivity: Addition of questions about alcohol- or drug-related problems experienced in the past 12 months and past 30 days (even if an incarcerated patient reports no use in those time periods). Such problems could include increased craving, for example, even in the absence of use – or in anticipation of release.
  • Similarly, RISE now includes questions about how much patient has spent on alcohol or drugs (including nicotine) in the past 30 days, (even if the patient reports no use in the past 30 days) – because these items may be used as currency in an incarcerated setting or patient may have purchased items with the intent to use at a later time.
  • Streamlining: Removal of the question, “Is the patient currently residing in Level 3.1 care?” since Level 3.1 is generally not available to patients who are currently incarcerated.
Version 3.0 Details:

Important Clinical Updates:

Version 3.0 makes significant updates to the tool:

  • clinical changes to the question structure
  • additional guidance and help messaging for delivering the interview
  • expanded response items

Version 3.0 integrates greater efficiency in navigating through the interview by streamlining the assessment and eliminating questions that are not applicable to the patient in response to a triggering item. These revisions are applicable in the Medical History; Drug and Alcohol; Legal Information; Family and Social History; and Psychological sections. This release also expands and improves available response options for a number of questions.

A detailed list of item changes and guidance videos can be found below:

Demonstration of the streamlining updates

Demonstration of the response item and guidance updates

CONTINUUM Re-Entry Interview Script Enhancement (RISE)

Version 3.0 also implements the RISE, for patients who are in a controlled environment and will soon proceed to re-entry back into the community. The RISE re-frames questions for the controlled environment context so that patients are prompted to respond using more appropriate timeframes:

  • past (prior to entering the controlled environment)
  • present (within the controlled environment)
  • future (after community re-entry)

The RISE enhancements are only applicable for agencies that have specifically asked to enable the functionality. If your agency has patients who are in a controlled environment and will soon proceed to re-entry into the community, please reach out to CONTINUUMSupport@FEIsystems.com to discuss enabling the RISE. A guidance video demonstrating the RISE functionality will also be made available on the ASAM CONTINUUM website for applicable agencies.

Version 3.0 Updated Item Changes

  • A.a.0090: This item now asks whether the patient was released from jail or prison within the past 6 months, but no longer asks whether the patient has been in a penal or chronic care setting within the past 14 days. The update to this item aligns it with current federal regulations for opioid treatment program admission.
  • B.a.0100, B.a.0120: These items now ask whether and when the patient has been tested for sexually transmitted diseases and tuberculosis. A “Not tested/not sure” response option also has been added to the tuberculosis question (B.a.0120). If an interviewer selects “Not sure/possibly” for B.a.0100, or “Not tested/not sure” for B.a.0120, the Assessment Report will include language alerting the clinician that the patient may need testing. These responses will also be included in the “Problem List” of the Narrative Report.
  • B.a.0180: This item has been updated to include SSI and disability payments in the query of possible payment sources for disabilities.
  • B.a.0460: This item (“…reemergence of acute symptoms that can be safely addressed only in a medically-monitored setting?”) now has a new instruction stating that a response of “yes” may escalate the Final Level of Care intensity and/or require Biomedical Enhanced Services (BIO).
  • B.a.0010: The question structure and instructions to the interviewer (“What physical or medical problems have you had…?”) have been revised so that the interviewer is now asking the question to the patient directly.
  • D.a.0010: The question structure and instructions to the interviewer (“Which substances have you had problems with?…”) have been revised and expanded to focus more on problems related to use and priorities rather than listing all substances the patient has ever used. Also, in the drug category response options, ecstasy has been reclassified as a hallucinogen.
  • D.v.0130: The first response option for this item has been edited to read “Has detailed & comprehensive sense of the role of treatment vs. need for personal efforts – OR no relapse risk likely.” This additional help text has been added to the information icon for this item to help guide the clinician in choosing the appropriate response for a broader range of patient circumstances.
  • F.a.0360: For this item (“How much help will this person (or these persons) need to assist…?”) the blue “i”nformation button now provides a detailed explanation for each response option.
  • F.a.0040: This item, which asks whom the patient lives with, now allows users to endorse multiple response options.
  • F.a.0460: This question asks whether the patient is able to locate and get to community resources safely. The response options now include more nuance: “No or unknown” and “Yes (or patient is remaining in a residential or controlled environment where resources are available)”.
  • G.a.0030: The question has been re-worded so that the clinician asks up front about difficulties with mood, sleep, energy, nerves, eating, thinking, memory, or getting along with others. This change will allow the clinician to begin collecting data about psychological and emotional symptoms. Additionally, “Cognitive delays (developmental delays or borderline mental function)” has been added as a response option for this item.
  • a.1660, G.a.1670, G.a.1580, G.a.1590, G.a.1600, G.a.1620, G.a.1630, G.a.1640G.a.1660, G.a.1670: More detail has been added to the response options for items about suicidal attempts (gestures), and help messages have been added to these items, to help guide the clinician in selecting the appropriate response.
  • G.b.0180, G.b.0270: Response options for these items have been updated to include “No or not applicable.”
  • G.b.0240, G.b.0270: Blue “I”nformation button help messages have been added to these items.

Version 3.0 Streamlining Updated Item Changes:

  • a.0060: This item now has an additional response option of “Prison.”
  • a.0010: In order to substantially shorten and streamline the interview, if the patient does not have any medical conditions, most of the medical section will now be suppressed.
    However, several key medical questions related to pregnancy, infectious disease and/or medical conditions that could present risk during withdrawal management will remain in the assessment.
  • a.0430, B.a.0450, B.a.0460: These medical questions are gaining an “Unable to assess” response option. If the user selects this option for any of these items, the items will appear in the “Problem List” section of the Narrative Report; and an alert will appear in the Assessment Report stating that the interviewer was unable to assess what the question is asking, and recommending further medical evaluation.
  • f.0010, D.f.0020, D.f.0030, D.f.0040, D.f.0050, D.f.0060, D.f.0070, D.f.0080, D.f.0090, D.f.0100, D.f.0110: In order to substantially shorten and streamline the interview, these CINA scale questions will be suppressed if the patient reports no use of opioids in the past 15 days (exception: up to 30 days for methadone or buprenorphine, since these are longer lasting agents).
  • h.0050: This question (“…readmission: Does the program physician judge Opioid Treatment Services (OTS) readmission to be medically indicated?”) will be suppressed if the patient has not previously completed at least 6 months of Opioid Treatment Services with voluntary withdrawal management.
  • k.0010, D.k.0020, D.k.0030, D.k.0040, D.k.0050, D.k.0060: These CIWA scale questions will be suppressed if the patient reports no use of alcohol or sedatives in the past 15 days.
  • r.0040: This item about nicotine route of administration now includes “Smoke/Vape.”
  • w.0100: This question, which asks whether the patient is displaying signs of withdrawal, will be suppressed if the patient reports no use of any drug category within the previous 15 days (30 days for methadone/buprenorphine).
  • a.0020, F.a.0070, F.a.0100, F.a.0110, F.a.0130, F.a.0140, F.a.0360: To substantially shorten and streamline the interview, these questions, in the “Legal” and “Family and Social History” sections, will now be suppressed for patients who report no history of alcohol or other drug use.
  • a.0070, F.a.0110, F.a.0130, F.a.0140: These questions will now include an additional response option of “Unknown.”
  • a.0550: This question, which asks how much staff support is needed for a patient transitioning back to the community, will now include a new response option “Needs contact about once per month” for greater specificity.
  • a.0030: To substantially shorten and streamline the interview, if the patient endorses no psychological or emotional problems in this item, many of the psychological symptom questions that follow will now be suppressed.
  • a.0090, G.a.0130, G.a.0170, G.a.0210, G.a.0250, G.a.0290, G.a.0330, G.a.0370, G.a.0410, G.a.0450, G.a.0490, G.a.0530, G.a.0570, G.a.0610, G.a.0650, G.a.0690, G.a.0730, G.a.0770, G.a.0810, G.a.0850, G.a.0890, G.a.0930, G.a.0970, G.a.1010, G.a.1050, G.a.1090, G.a.1130, G.a.1170, G.a.1210, G.a.1250, G.a.1290, G.a.1330, G.a.1370, G.a.1410, G.a.1450, G.a.1490, G.a.1530, G.a.1570, G.a.1610, G.a.1690:  To substantially shorten and streamline the interview, for patients who endorse past-24-hour psychological or emotional symptoms, but deny any alcohol or other drug use, questions asking whether these symptoms were due to alcohol or other drug use or withdrawal will now be suppressed.
  • b.0150: To substantially shorten and streamline the interview, this item (whether risk of harm to self or others is related to alcohol or other drug use) will now be suppressed for patients who endorse psychological/psychiatric risk but deny any use of alcohol or other drugs.
  • a.0030: To substantially shorten and streamline the interview, this question (how soon the patient is likely to respond to withdrawal management care) will now be suppressed for patients who deny any use of alcohol or other drugs, or who deny use within the past 15 days (30 days for methadone).
  • a.0090, H.a.0100, H.a.0110, H.a.0120, H.a.0130: To substantially shorten and streamline the interview, these medical questions, which appear in the Interview Completion section, will now be suppressed if the patient previously denied having any medical problems.
  • a.0190: This question (whether the patient would recommend the treatment program to a friend in need of help), will have an additional response option of “Not applicable” so that it applies to patients who have not yet begun treatment.

Important Clinical Updates:

  • Gender options added into the client profile for CONTINUUM: This update implements CDC, National Academy of Medicine, and similar recommendations for high-quality, patient-centric care, by:
    1. Expanding CONTINUUM’s gender identity options
    2. Integrating items to capture sex-at-birth and patient-preferred gender pronouns
    3. Allowing for pregnancy status to be collected on all individuals
  • CONTINUUM – General Information & Legal Section – Sync jail and incarcerated question: This update improves data integrity in the General Information and Legal Information sections between two items that query the number of days the patient has spent in a controlled environment in the last month. If responses to these items do not match, the Interviewer will now automatically receive a notification. Additionally, the response value for number of days in the past 30 days will be restricted to between 0 and 30.
  • Changes to Accommodate Abuse-Neglect of a Minor or Elder: This revision in the Family and Social History section improves the abuse and neglect questions by:
    1. Updating the wording of some items
    2. Adding blue “i” button help information associated with the change
    3. Improving the sequencing of these items
    4. Introducing a free-text field so the Interviewer can describe any risks
    5. Providing guidance and resources on duty to report requirements
  • Updates to account for patient self-reported data: In response to the COVID-19 pandemic and needs for telehealth interviewing or interviewing by non-medical/nursing personnel, CONTINUUM now provides improved guidance on assessments collected via phone or videolink, including:
    1. Information icons for the CIWA and CINA withdrawal assessment items now include instructions to allow patient self-report in the event that the interviewer is unable to assess.
    2. The Narrative and Summary Reports specify that assessments collected via telehealth interview or by non-medical/nursing personnel will contain more patient self-reported data and that self-reported data may impact conclusions or recommendations

ASAM CONTINUUM Assessment Updates:

  • Corrected typo found in Review Section: In the Review section, screen question I.a.0030 misspelled the word “received.” This has now been corrected.

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.