American Society of Addiciton Medicine

Release Notes

ASAM CONTINUUM

Release Notes

Release Notes – Version 3.18 (January 10, 2023)

New Response Option for Pronouns and Gender Identity: “Interviewer Declined to Ask”

In both CONTINUUM and CO-Triage, for these two items:

  • What is your Gender Identity?”   [GndrId (CONTINUUM only)]
  • What are your Pronouns? [Prnouns/TPrnouns (CONTINUUM/CO-Triage)]


    If “Interviewer declined to ask” is selected:

  • The Narrative and Summary Reports (CONTINUUM) will output “they/them” where pronouns are used.
  • Report headers will only show the preferred name and will not specify pronouns or gender identity.

    These changes have been made in response to a user request. This modification will allow interviewers more flexibility when assessing patients who express discomfort about being asked for their pronouns and gender identity.

CONTINUUM Narrative Report

In the CONTINUUM Narrative Report “Identifying Information” section, Gender Identity and Pronouns will now appear underneath the “Name” field, while Race and Ethnicity will be displayed under “DOB.” This change is intended to facilitate review of demographic information.

 



 

Release Notes – Version 3.17 (December 6, 2022)

End User License Agreement (all products):  

The end user license agreement has been updated. Specifically, the previous “Indemnification” paragraph was removed and was replaced with a new paragraph titled “Liability: Breach Notification.”  CONTINUUM and CO-Triage users will be asked to acknowledge receipt of the updated end user license agreement. 

 Support Ticket Form (all products):  

In both CONTINUUM and CO-Triage, users will now be able to submit a support ticket directly from within the assessment. A “CONTINUUM Support” link will be available in the upper lefthand corner of the screen, next to an envelope icon (please see orange arrow and box below).  

When “CONTINUUM Support” is selected, it will generate a new tab within the browser. The “CONTINUUM Support” tab will have prefilled information including assessment ID, current date, and user’s email address. The user can also add up to 4 additional email contacts. All email contacts will receive an email confirmation. The user can respond to the support email confirmation and send any additional information or documentation related to the issue. 

 All inquiries can be entered in the “Description of Issue” field.

 CONTINUUM Question Updates: 

  • Medical History section: To simplify the addition of information about biomedical diagnoses, at the beginning of the Medical History section, we have reduced the two comment boxes down to only one. 
    • Previously, when interviewers endorsed any biomedical issue in ASm01a (“What physical or medical problems have you had, of any kind?”), comment box ASm01bN appeared (Please describe specifically). 
    • If interviewers selected “Other” for ASm01a, a second comment box would appear (ASm01aN – List the other medical problems mentioned). 
    • Now, only ASm01aN [Comment box: Please provide further detail (e.g., specific diagnoses)] will display for any selection in ASm01a (“What physical or medical problems have you had, of any kind?”), except “None.”
    • ASm01bN (comment box – Please describe specifically) has been eliminated to reduce redundancy. 


  • Medical History section: To allow interviewers more flexibility when selecting HIV/TB test dates, we have updated the information text icon for the HIV and TB test questions: 
    • (ASm03cRn) “If you have ever been tested for HIV/AIDS, when were you last tested?”
    • (ASm03eRn) “When were you last tested for TB?” 
    • The information icon for both items now reads (new text in bold), Click on arrow to choose time frame. If the patient has only been tested once, enter that date. Estimate if not certain or enter the approximate time frame in the Comments question (MedInfoN) at the bottom of the page.” 
  • Psychological History section: To assist interviewers in entering information about specific mental health diagnoses, comment box ASp01CN will now appear for any response option selected for item ASp01c (“What psychological or emotional problems have you had?”): 
    • Previously, ASp01CN (comment box – List the other problems mentioned) appeared only when the interviewer endorsed “Other” for ASp01c. 
    • Now, ASp01CN will appear for any selection in ASp01c, and will be reworded to read: Please provide further detail (e.g., specific diagnoses). 
    • If the interviewer selects “Other,” comment box ASp01CN will be a required item; otherwise, it will be optional. 
  • Psychological Interviewer Rating section: We have also added a new comment box, ASp19jC, underneath item ASp19j [Given the history and any new information, what active psychiatric diagnoses does the patient seem to have (other than substance use disorder)?]
    • ASp19jC will read, Please provide further detail (e.g., specific diagnoses).
    • If the interviewer selects “Other,” comment box ASp19jC will be a required item; otherwise, it will be optional.  


Release Notes – Version 3.16 (October 11, 2022)

CONTINUUM and Co-Triage Question Update:  

  • Drug and Alcohol Section – Used Substances Subsection: For the SubsUse question, we have reworded response options to clarify that the question applies only to substances currently causing a problem. The response option "Any other substances (e.g., high-dose caffeine, steroids, etc.)" will now read, "Other problem substances (e.g., high-dose caffeine, steroids, etc.)."
    • SubsUse in standard CONTINUUM reads: “Which substances have you had problems with? Think about alcohol or drug use that is currently a problem or could become a problem again. Which substances would you like help with?”
    • SubsUse in CONTINUUM RISE reads: "Which substances have you had problems with prior to [your arrest/entering jail or prison/rehab/the halfway house/hospital]? What about since then? Think about alcohol or drug use that is currently a problem or could become a problem again. Which substances would you like help with?"
  • We are also updating this SubsUse response option in CO-Triage to align with the change to CONTINUUM.
    • In CO-Triage, the response option previously read, “Any other drug of abuse (e.g., high-dose caffeine, steroids, etc.)” but will now read, “Other problem substances (e.g., high-dose caffeine, steroids, etc.).”

CO-Triage Report:

  • To clarify whether the interviewer left additional comments for given items, when the interviewer does not enter text in Comment Boxes (for questions DrgInfoN, T5N, T1N, T2N, T3N, T4N, and T6N), the Triage Report will read, “The interviewer did not have any comments for this section.”
  • To enhance language in the Triage Report, when interviewers enter information about more than one medical or psychological problem in the Comment Boxes, the report text now reads:
    • Dimension 2 – Medical Conditions and Complications, ASm06PxN: “Other medical problems”
    • Dimension 3 – Emotional, Behavioral, or Cognitive Conditions, ASp01cN: “Other psychological or emotional problems”

      If the interviewer does not endorse other medical or psychological problems in the instrument, the report will not print these items.


       

Release Notes – Version 3.15 (August 30, 2022)

Narrative Report Updates  

  • We have improved how CONTINUUM response options result in sentence outputs in the Narrative Report. These changes affect the standard version of CONTINUUM.
    • Alcohol & Drug Section,   Client Perception of Severity of Alcohol and Drug Problems   and Desire for Treatment subsection
      • In CONTINUUM, for the question   "How troubled or bothered have you been in the past 30 days by the noted alcohol problems?" (ASd23a),   when responding "considerably” or "extremely," the Report sentence will read "considerably bothered" or "extremely bothered." (Prior to these updates, the text read "bothered considerably" or "bothered profoundly.")
      • In CONTINUUM, for the question   "How troubled or bothered have you been in the past 30 days by these drug problems?" (ASd23d),   when responding "considerably” or "extremely," the Report sentence will read "considerably bothered" or "extremely bothered." (Prior to these updates, the text read "bothered considerably" or "bothered profoundly.")
    • Psychiatric Section,  in the Severity of Emotional and Psychological Problems   and Desire for Treatment subsection
      • Similarly, in CONTINUUM, for the question   "How much have you been troubled or bothered by the previously discussed psychological or emotional problems in the past 30 days?" (ASp12),   if the interviewer responds "considerably" or "extremely,” the Report sentence will read "considerably bothered" or "extremely bothered."   (instead of “bothered considerably" or "bothered profoundly.")
  • In CONTINUUM, any language entered by the interviewer in the Comment Box of any section will appear in the Narrative Report with quotations.
    • Alcohol & Drug, Employment, Family/Social, Legal, Medical, Psychiatric, and Clinical Summary Notes sections:
      • The statement will begin with Comments: followed by the text entered by the interviewer with quotations at the beginning and end of the statement.
  • We have streamlined information in the Narrative Report regarding patients’ substance use.  
    • Alcohol & Drug Section, Lifetime and Past 30-Day Use subsections 
      • If the patient did not endorse any drug or alcohol use,   then the Narrative Report will simply state:   “Patient did not endorse any alcohol use” or “Patient did not endorse any drug use.”    

        Summary Report Updates

  • Critical Items Section
    • Any language entered by the interviewer in the text field for ASf19iN [“Describe the abuse/neglect risk and any resulting actions taken by the interviewer or supervisory staff”] in CONTINUUM has been added to the Summary Report with quotations. In the Summary Report, the statement will begin with,   The following critical psychological/psychiatric item(s) were noted in this assessment: The interviewer commented that…   followed by the text, as entered by the interviewer, in quotations.  

        

      Question Updates

  • In CONTINUUM’s on-screen interview, Psychological Section  
    • The language for the header,   “Are you worried about having another attack?” (immediately above the block containing ASp04dL) has been changed to “Have you worried about having another attack?” to reflect the past tense orientation of response options for this header (In your lifetime/In the last month/In the last 24 hours). 

        

      Response Updates

  • In CONTINUUM’s on-screen interview, Interview Completion Section
    • To ensure users obtain accurate information about a patient’s willingness to take new medications as prescribed, response options have been updated for the question (see the change in bold below):

      "If any medications are being or will be prescribed, is the patient willing and able to self-administer these with good compliance?   (Responding "NOT willing or able to safely self-administer the medication" may escalate the Final Level of Care intensity and/or require Biomedical Enhanced Services (BIO). If unsure, consult a nurse or physician.)" (Post06)

      Response options now include:

      • NO medications are currently prescribed or planned
      • Patient is currently on medication, or medication will be prescribed, and IS willing and able to self-administer with good compliance
      • Patient is currently on medication, or medication will be prescribed, but patient is NOT willing or able to safely self-administer the medication 

        User Interface Updates

  • New on-screen pop-up error messages will increase the accuracy of the patient’s substance use and treatment history.
    • CONTINUUM Drug and Alcohol Section/  Additional Addiction and Treatment Items
      • If interviewers endorse a substance for:  

        “Which substance is the major problem?” (ASd14, standard) 

        or 

        “Which substance has been the major problem or could become the major problem when you re-enter the community?” (ASd14, RISE) 

        that does not match any of the substances selected for: 

        “Which substances have you had problems with?” (SubsUse, standard) 

        or 

        “Which substances have you had problems with prior to [your arrest/entering jail or prison/rehab/the halfway house/hospital]?” (SubsUse, RISE),  

        Then an error message will read, “ERROR: [Substance] was not selected in the Used Substances section. Please select a value that matches one of the responses endorsed in the SubsUse question.”

    • CONTINUUM Drug and Alcohol Section/Addiction Treatment History
      • If interviewers endorse “Alcohol and Drug” for the type of treatment the patient has received (PrevTrmt),  

        but then select 0 for, “How many times in your life have you been treated for alcohol use problems?” (ASd18a) 

        and/or select “0” for, “How many times in your life have you been treated for drug use problems?” (ASd18d) 

        or 

        If interviewers endorse “Alcohol only” in PrevTrmt,  

        but then select 0 for, “How many times in your life have you been treated for alcohol use problems?” (ASd18a) 

        or 

        If interviewers endorse “Drug only” in PrevTrmt,  

        but then select “0” for, “How many times in your life have you been treated for drug use problems?” (ASd18d) 

        Then they will see an error message that reads, “ERROR: The response must be greater than zero based on your answer to the Question PrevTrmt.” 

Co-Triage/Triage Report 

  • Language entered by the interviewer in Co-Triage comment boxes (DrgInfoN, T5N, T1N, T2N, T3N, T4N, and T6N) will appear in the Triage Report with quotations.
    • The statement will begin with Comments: followed by the text entered by the interviewer with quotations at the beginning and end of the statement. 

Release Notes – Version 3.14 (July 19, 2022)

The American Society of Addiction Medicine is pleased to announce that version 3.14 of the ASAM CONTINUUM and CO-Triage software has been released. Details about the updates to this software version can be found below and will be posted on ASAM CONTINUUM website. In addition, updates appear in both the standard version of CONTINUUM and the RISE.

User interface

●      With opioid overdose deaths rising rapidly, it is critical that naloxone, the overdose reversal medication, is in the hands of anyone who needs it. ASAM CONTINUUM users can support patients' safety by talking to them about naloxone, providing overdose prevention training resources, and ensuring patients and their loved ones have access to the medication. We have implemented the following to remind clinicians to provide education and resources to the patient:

○      Drug and Alcohol Section, Additional Addiction and Treatment Items subsection: A pop-up box with naloxone information will appear if the patient has endorsed opioid use and at least one overdose experience in Question ASd17e, “How many times have you overdosed on drugs or alcohol?”

○      Summary Report: ​​Where applicable, the Critical Items section will state, “[Patient Preferred Name] indicated that [he/she/they] has overdosed on alcohol and/or drugs in the past 24 hours. Suspected recent overdose requires rapid evaluation by physician/psychiatrist or emergency room. If the overdose was due to opioids, please equip the patient and loved ones with naloxone.”

Narrative & Summary Reports

●      DSM-5 Diagnosis section, Diagnostic Findings subsection: ICD-10 codes and descriptions have been added to improve usability for treatment planning, coding, and insurance authorization.

○      For patients with substance use disorder diagnoses, reports will now display the following alongside the DSM-5 diagnosis, criteria met, and severity of the substance use disorder:

■      Specific ICD-10-CM diagnosis and billable code, e.g., ICD-10 F10.20 Alcohol dependence

Release Notes – Version 3.13 (June 7, 2022)

In the Drug and Alcohol section:

  • In the Opioid Treatment Services sub-section, ASd25j has been updated to:

    Does the program physician or authorized healthcare professional judge Opioid Treatment Program (OTP) readmission to be clinically appropriate? 

  • The added phrase (in bold) accounts for situations in which healthcare professionals other than physicians make decisions regarding OTP admissions.

    • The response options for this item now include "Yes/No/Not applicable."

    • New help/hint text for this item reads,  “Choose not applicable if no program healthcare professional is currently available to make this assessment. An authorized healthcare professional can include an advanced-practice nurse, physician assistant, or advanced-practice pharmacist.”

  • Consistency checks have been added to the Alcohol Use sub-section to improve data quality. Now, error messages will appear, alerting the user to data discrepancies in the following scenarios:
    • If the number of days entered for the patient's use of alcohol to intoxication in the past 30 days exceeds the number of days entered for any alcohol use in the past 30 days;
    • If the value entered for lifetime duration of alcohol use to intoxication exceeds the value entered for lifetime duration of any alcohol use;
    • If the value entered for the patient's last use of alcohol to intoxication is incompatible with the value entered for the patient's frequency of alcohol use to intoxication in the past 30 days (e.g., the patient's last use of alcohol to intoxication was 25 days ago, but the interviewer reports that the patient used alcohol to intoxication on 7 of the past 30 days).

In the Medical History section:

  • We have added two new items that enable clinicians to enter dates for the patient's latest tests for HIV/AIDS (ASm03cRn) and tuberculosis (ASm03eRn), if applicable. Test dates will now appear in the Narrative Report Problem List.

In the Summary and Narrative Reports:

  • For patients with a history of suicide attempts, the Summary Report Critical Items section and the Narrative Report Problem List will display the patient's most recent suicide attempt (e.g., past 24 hours, past month) to enhance visibility and support treatment planning.
  • Additionally, any past 24-hour suicide attempt will be noted in the Narrative Report, Psychiatric Section, at the start of the second paragraph (titled “Severity of Emotional and Psychological Problems and Desire for Treatment”).

Previous Updates

Version 3.12 (April 26, 2022)
Version 3.11 (March 15, 2022)
Version 3.10 (February 1, 2022)
Version 3.9 Release (December 21th 2021)
Version 3.8 Release (November 16th 2021)
Version 3.7 Release (October 5th 2021)
Version 3.6 Release (August 17th 2021)
Version 2.7 Release August 2019
Version 2.8 Release November 2019
Version 2.9 Release December 2019
Version 2.10 Release February 2020
Version 2.10.1 Release March 2020
Version 2.11 Release April 2020
Version 2.12 Release May 2020
Version 2.13 Release June 2020
Version 3.0 Release July 2020
Version 3.1 Release August 27th 2020
Version 3.1.2 Release (September 28th 2020)
Version 3.2 Release November 20th 2020)
Version 3.2.4 Release (February 24th 2021)
Version 3.3 Release (April 20th 2021)
Version 3.3.1 Release (April 28th 2021)
Version 3.3.3 Release (April 30th 2021)
Version 3.4 Release (June 1st 2021)
Version 3.5 Release (July 8th 2021)

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