Tennessee Outcomes Measurement Tennessee Outcomes Measurement System (TOMS) System (TOMS) v.1.3v.1.3

Tracking and Improving Behavioral Health Care Throughout Tennessee

What is TOMS?

• The Tennessee Outcomes Measurement System is a data gathering and analysis system that Tennessee providers will use to collect self-report outcomes data and obtain consumer progress reports.

• It is sponsored by the state of Tennessee and the Tennessee Association of Mental Health Organizations (TAMHO), and has been developed jointly with TeleSage, Inc.

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.

What are the Benefits of Outcomes Tracking?

• Consumer: Empowerment in recovery process; treatment planning with clinician

• Clinician: Identify consumer strengths and areas to work on in treatment; monitor changes over time

• Agencies: Quality improvement; meet requirements of certification, accreditation and/or payor organizations

• TAMHO: planning and quality improvement; identify best practices

• State: planning and quality improvement; develop best practices and state benchmarks; demonstrate accountability for resources

Guiding Principles

• Minimal burden on consumers and providers

• User-friendly technology

• No dedicated hardware or additional software needed onsite

• Actionable reports for clinicians and agencies

• Flexibility and ability to incorporate feedback from stakeholders

The TOMS Instruments

Estimated Consumer Completion

Time: 6-12 minutesAdult Survey

Total: 51 items

Youth SurveyTotal: 59 items

Parent/Guardian SurveyTotal: 55 items

Survey DomainsAdult

• Depression

• Anxiety

• Hostility

• Psychoticism

• Physical Impairment

• Social Functioning (Peer)

• Social Functioning (Spouse)

• Social Functioning (Family)

• Recovery

• Core Functioning

• Medication Compliance

• Medication Side Effects

• Substance Use

• Housing

• Transportation

• Safety

• Legal

• Work Functioning

• Service Utilization

Survey DomainsYouth and Parent/Guardian

• Problem Severity– Internalizing– Externalizing– Delinquency

• Hopefulness

• Functioning

• Inclusion in Mental Health Services

• Medication

• Legal

• Service Utilization

• School

• Self-Harm

• Housing

• Substance Abuse

(youth only)

Sample ItemsAdult Survey

In the past 7 days … Never Rarely

Some-times Often

Almost

Always

1. I felt sad. 1 2 3 4 5

5. I felt nervous. 1 2 3 4 5

18. I heard voices when I was alone. 1 2 3 4 5

Survey Intervals

New Clients• Intake, +3 months, +6 months, +12 months, +24

months, +36 months, etc.

Existing Clients* (phase in at patient review)

• Intake, +12 months, +24 months, +36 months, etc.

*Existing clients are those who have been receiving services at your agency for at least one month.

PHONEPHONE

PAPER*PAPER*

WEBWEB

Immediate Immediate ReportsReports

Export in any Export in any formatformat

PCPC

ODBCODBC DatabaseDatabase

Technology Options for Technology Options for Survey AdministrationSurvey Administration

*Rapid Data Entry

The TOMS Website

The TOMS Website

Features available as of March 15, 2007:• Adult, Youth and Parent/Guardian paper, online & phone

surveys • Rapid Data Entry • Adult, Youth and Parent/Guardian clinic reports• Assessments Due page• Edit Clinician page• Email Preferences page• Help features such as detailed staff instructions, Frequently

Asked Questions page, and video training modules

Paper Survey Administration

Phone Survey Administration

Online Survey Administration