1 FAST Information System Farrokh Alemi, PhD

2 Design Basis Interviews of interested parties Administrative Office of U.S. Courts PACTS Current system (MHIS CAP BMC) Current forms Standardized instruments for outcome evaluations Addiction Severity Index, Composite International Diagnostic Interview, Texas Christian University Risk assessment, Treatment Fidelity Scale.

3 Minimum Data 1. Minimum data set necessary for tracking cases “Not a medical record but a case tracking system.” A previous system went unused. Limited number of open ended commentary.

4 Flexible 1. Normalized database design Data stored differently than input forms Allows several inputs for same field (e.g. person’s address) Data kept in one place even when it has multiple uses Allows for easy searches and reports. For example, all clients cared for by a provider working at two treatment services can be found in one place Only facts kept. Composites of facts calculated. 2. Codes entered as data Allows easy change over time Current system was not in Normal form

5 Normalization Counter-intuitive data structures Leads to numerous tables Basis of all modern database structures Difficult to set up, easy to use & modify

6 Event Based Does not include various client assessments Includes milestones behind assessments For example, treatment participation is included while client attitudes towards readiness for treatment not included. Rates estimated from time to event For example, frequency of drug use is estimated from time between reported use

7 Added Outcomes Treatment participation Hospitalization Self report of relapse Drug test results Medication compliance Clinic visit and diagnoses Conflict & abuse within key relations Change in weapon permits Loss of children’s custody Employment Educational progress HIV/AIDS risks & test results Recidivism Homelessness

8 Multiple Identity Allowed a person to have multiple roles An arrested defendant who becomes an outreach provider. A FAST social worker who also works part time at a mental health clinic. Allowed a client to have multiple names & aliases Allowed images of clients and markers

9 Secure Online Encrypted Personal Identifiers Trail of tables visited or modified No physical deletion. All entries kept.

10 Data Access Faxed paper reports to central database Current process Web access Allows tailored input forms for various providers reminders PDA access Allows providers who do not have computers easy access Data transfers Between jail system & FAST information system Between VA system & FAST information system

11 Probation Officers Can Use PDA for Reporting Outcomes

12 Sample Elements in the System

13 Elements of Criminal Justice

14 Case Plan Elements

15 Client Information Elements

16 Drug Use & Test Elements

17 Elements to Describe a Person

18 Elements to Monitor Progress

19 Elements to Describe Services

20 Elements to Set Security

21 Details of Data Elements Provided in Attached Report

22 Actions Recommended 1. Walk through of one to five clients 2. Revisions in the data structures 3. Construction of input forms and output reports 4. Completion of system 5. Training