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The Iowa Consumer Outcomes Measurement System (ICOMS) Walk-Through April 2, 2009. About Telesage, Inc. Over $4.5 Million in NIH Grants Since 1998. Automated Telephone Technology for Mental Health Self-Report ASI Via Phone and Internet

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over 4 5 million in nih grants since 1998
Over $4.5 Million in NIH Grants Since 1998
  • Automated Telephone Technology for Mental Health
  • Self-Report ASI Via Phone and Internet
  • Self-Report Teen-ASI Via Phone and Internet
  • Application of IRT to Mental Health Outcomes Tracking
  • Enhancement of IRT Domains for State Instruments
  • Software for Internet and PC SCID Administration
  • Depression Screener for Perinatal Women
examples of telesage s experience in state outcomes tracking
Examples of TeleSage’s Experience in State Outcomes Tracking
  • Washington
  • Tennessee
  • Iowa
  • Pennsylvania
  • Louisiana (Pending)
complete security
Complete Security

Data Recovery

  • Mirrored RAID array drives
  • Encrypted nightly backups to secure off-site locations

Data Security

  • HIPAA Compliant
  • 21-CFR Part 11 Compliant
what is icoms
What is ICOMS?
  • The Iowa Consumer Outcomes Measurement System is a data gathering and analysis system that Iowa providers will use to collect self-report outcomes data and obtain consumer progress reports.
  • It is sponsored by Iowa MHDS, and has been developed jointly with TeleSage, Inc. TeleSage has experience developing outcomes tracking systems in Washington, Tennessee, and Pennsylvania using instruments that are compliant with SAMHSA’s NOMs.
what are consumer outcomes
What are Consumer Outcomes?
  • Consumer outcomes are indicators of quality of lifethat 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
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
  • Provider: Quality improvement; meet requirements of certification, accreditation and/or payor organizations
  • Iowa MHDS: planning and quality improvement; identify best practices
  • State: planning and quality improvement; develop best practices and state benchmarks; demonstrate accountability for resources
guiding principles
Guiding Principles
  • Minimal burden on consumers and providers
  • User-friendly technology
  • No dedicated hardware or additional software needed onsite
  • Actionable reports for clinicians and providers
  • Flexibility and ability to incorporate feedback from stakeholders
the icoms instrument
The ICOMS Instrument

Telesage, Inc. has been the recipient of several NIH grants to develop state-of-the-art outcomes tracking instruments for mental health consumers.

The ICOMS adult mental health instrument will be introduced first, with instruments for youth mental health consumers and their caregivers to follow.

Estimated Consumer Completion Time: 6-12 minutes

Adult Survey - Total: 51 items

survey domains adult




Physical Impairment

Social Functioning (Peer)

Social Functioning (Spouse)

Social Functioning (Family)


Core Functioning

Medication Compliance

Medication Side Effects

Substance Use





Work Functioning

Service Utilization

Survey DomainsAdult
design of survey
Design of Survey
  • The past seven days as time period
  • Five-point response scale (never, rarely, sometimes, often, always)
  • A single short sentence
  • One concept per question
  • 5th grade reading level

(Cognitive interviewing conducted with SPMI clients for all items)

design of survey continued
Design of Survey (continued)
  • No contingent questions (if…, then…)
  • No lead phrases or internal punctuation
  • No abstract interpretations possible
  • No idiomatic language
  • No language that can be perceived as morally judgmental

(Cognitive interviewing conducted with SPMI clients for all items)

survey intervals
Survey Intervals

New Clients

  • Intake, +3 months, +6 months, +12 months, +18 months, +24 months, etc.

Existing Clients*

  • Intake, +6 months, +12 months, +18 months, +24 months, etc.

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

survey domains mhsip
Survey Domains (MHSIP)
  • Access, 7 items
  • Appropriateness/Quality, 11 items
  • Outcomes, 13 items
  • Prevention, 4 items

*Total: 35 items


Technology Options for Survey Administration

Immediate Reports






Export in any format

icoms clinician report
ICOMS Clinician Report
  • ICOMS Clinician Reports are an informative and easy-to-read summary of a consumer’s survey(s).
  • They contain graphs and summary sentences of important questions, as well as the consumer’s actual survey responses.
  • They compare the consumer’s responses over time, displaying responses at three time points (intake plus the two most recent assessments).
  • Graphs display the consumer’s domain scores.
description of potential icoms aggregate reports
Description of Potential ICOMSAggregate Reports
  • Quarterly Reports
    • A snapshot of ICOMS activity for each provider available every three months; shows response rates, demographics, and intake scores for all consumers.
  • Longitudinal Reports
    • Two different types of longitudinal reports are available every six months for assessing cohorts (to show change over time for consumers who have taken a three and/or six month follow-up survey), one at three months after intake and one at six months after intake.
  • Cross-Sectional Reports
    • Available every six months; contains data on all consumers and compares consumers in the provider to consumers statewide.
tennessee adult participation
Tennessee Adult Participation

Existing consumers have been in treatment for at least one month.

comparison of change at two agencies intake to 3 month agency cohort 2008 1 1 2008 to 6 31 2008
Comparison of Change at Two Agencies Intake to 3-Month Agency Cohort 2008 1/1/2008 to 6/31/2008
Comparison of Change at Two Agencies Intake to 3-Month Agency Cohort 2008 1/1/2008 to 6/31/2008 (cont.)
  • Improve consumer-level care through clinician feedback
  • Conduct program evaluations/develop Evidence-Based Practices
  • Provide data to agencies and clinics for individualized QA purposes including accreditation
  • Fulfill NOMs reporting requirements
  • Assure block grant eligibility
  • Report data to legislature with budget request
  • Demonstrate return on investment
  • Monitor impact of policy changes on consumers over time