1. Telesage Outcomes Measurement System (TOMS)
Tracking and Improving Behavioral Health Care
Throughout Louisiana

2. What is TOMS?
The Telesage Outcomes Measurement System is a state-of-the art means for collecting and reporting client self-report outcomes and obtaining regular client treatment progress reports.
TOMS is sponsored by the state of Louisiana Office of Mental Health (OMH), and has been developed jointly with TeleSage, Inc., based on experience in several other states implementing the system

3. What is TOMS?
Specifically designed for public behavioral health populations
Developed and used statewide in states of Tennessee, Iowa, Pennsylvania, & Washington
Uses short items stated in simple language and at 5th grade reading level
Easy to understand 5-point response scale: Never, Rarely, Sometimes…

4. What are Consumer Outcomes?
Consumer outcomes are indicators of quality of life that measure domains, such as symptom severity and social functioning, as well as recovery.
Outcomes must by definition measure change over time, so taking the survey at regular intervals is necessary.

5. Who Benefits from Outcomes Tracking?
Client
Clinician
Regions & LGE’s
Office of Behavioral Health

6. What are the Benefits of Outcomes Tracking?
For the Client
Contributes to a client-centered, recovery-oriented approach to treatment
TOMS self-assessment is from the client’s viewpoint
Gives the client a “voice” and empowerment in recovery process
Benefits client involvement in treatment with the clinician, contributing to outcome-focused care

7. Who Benefits from Outcomes Tracking?
For the Clinician
Contributes to client-centered, outcome-focused treatment
Provides a comprehensive & concise view of clients functioning & needs at-a-glance
Provides standard measures of symptom severity, functional impairment, medication adherence and changes in these over time

8. What are the Benefits of Outcomes Tracking?
For Regions/ LGE’s
Contributes to service quality improvement
Demonstrates accountability for resources
Helps to meet requirements for certification, accreditation and/or payor organizations
For Office of Behavioral Health/ DHH
Contributes to program quality improvement
Demonstrate accountability for resources
Helps identify best practices

9. Guiding Principles of TOMS Development
Minimal burden on clients and providers
Actionable outcome reports for clinicians and agencies
User-friendly and flexible administration technologies
Web-based: Minimal hardware requirements or additional software needed onsite
Telesage incorporates feedback from users contributing to ongoing system improvements

10. The TOMS Outcome Instruments
1-Adult (age 18+) Self-assessment
Total: 44 items
2-Youth (age 13-17) Self-assessment
Total: 53 items
3-Parent/Guardian (age 6-12) assessment
Total: 52 items
Estimated Client Completion
Time: 6-12 minutes

11. Self-assessment Domains - Adult -
Depression
Anxiety
Anger
Psychoticism
Physical Impairment
Social Functioning (Peer)
Recovery
Daily Functioning
Medication Adherence
Medication Side Effects
Substance Use
Emergency/Hospital Use
Work
Safety
Legal
Living Situation
Transportation

12. Self-assessment Domains -Youth and Parent/Guardian-
Depression
Anxiety
Anger
Attention Deficit
Hyperactivity
Conduct
Social Functioning (Peer)
Social Functioning (Family)
Empathy
Daily Functioning
Resiliency
Medication Adherence
Medication Side Effects
Participation in Physical and Group Activities
School
Substance Use
Emergency/Hospital Use
Work
Legal
Living Situation

13. Self-assessment Intervals
New Clients
Intake Self-assessment (within 30 days of admission)
Every 3 months thereafter
Existing Clients* (phase in at client review)
Intake Self-assessment (next treatment plan update)
*Existing clients are those who have been receiving services at your clinic for at least one month.

14. Technology Options for Self-assessment Administration
Immediate Reports
TOUCHSCREEN
ON-LINE (mouse) PC
PHONE (planned)
ODBC Database
PAPER*
Export in any format
*Rapid Data Entry

15. Touchscreen/ Online Survey Administration
Consumer completes online self-assessment 1

16. Touchscreen/ Online TOMS Administration- w/ OMH-IIS Users2
Provider receives instant results

17. Touchscreen/Online TOMS Administration- No OMH-IIS2
Provider can receive instant results

18. Paper Survey Administration

19. Louisiana TOMS Home Page

20. TOMS Secure Clinic Site

21. TOMS Clinician Report
TOMS Clinician Reports are an informative and easy-to-read summary of a client’s self-assessment(s).
They contain graphs and summary sentences of important questions, as well as the client’s actual self-assessment responses.
They compare the client’s self-assessment responses over time, displaying responses at four time points (intake plus the three most recent assessments).
Graphs display the client’s domain scores.
*Intake = Initial/First self-assessment completed

22. Sample Adult Clinician Report

23. Sample Adult Clinician Report

24. Sample Adult Self-assessment

25. Other Telesage Instruments
Client Quality-of-Care Surveys
(C’est Bon and La Fete programs)
Adult Survey (MHSIP-based)
Total: 42 items
Parent/Guardian Survey (YSS-F)
Total: 32 items

26. Client Quality of Care Domains
Access to Care
Appropriateness/Quality of Care
Outcomes of Care
Treatment Involvement

27. TOMS Administration Process
TOMS is completed at the point-of-service prior to a regular treatment session at the clinic
TOMS is introduced by reception staff using the Client Information Sheet, which also accomplishes client informed consent
The client is instructed on how to log-on and use the Touchscreen/On-line self-assessment via the TOMS Instruction Sheet
When the client completes the self-assessment, TOMS automatically prepares the outcome report
The TOMS is then ready for the next client

28. TOMS Implementation- Where we are now…
TOMS Initial Implementation
Started March, 2010
6 Initial Implementation Sites
Lafourche MHC
Terrebonne MHC
Lake Charles MHC
Shreveport MHC
Ruston MHC
Jonesboro MHC

29. TOMS Implementation- Where are we now
As of 06/04/10: Number of self-assessments administered:
900+
Positive Feedback from Clients & Clinicians
Clients think it’s FUN!!
Clinician’s have instant useful information
Initial Implementation Report

30. TOMS Implementation- Some Lessons Learned
Importance of staff who will introduce & administer the TOMS
Have someone nearby should client need assistance
Make TOMS a routine part of everyday practice
Administer prior to Service Session
Offer option of Touchscreen or Mouse
Begin with New Admissions- establish baseline

31. TOMS Help Ongoing Support Thru weekly implementation GoToMeetings
TOMS Website
Technical Issues with the Site or Self-assessment
Contact TeleSage at

32. TOMS Help continued Other Contact Annette Giroir at
(225) or
Or Randall Lemoine at
(225) or

33. In conclusion…
TOMS provides a state-of-the-art, easy-to-administer client outcome measurement system for monitoring and improving service outcomes at both the level of the individual client-clinician and the local/state administrative levels
Q&A

34. Our TOMS is up!
Thank You!