Netsmart Supports Use of Psychometrically Valuable Assessments to Improve Care and Treatment

From Data toKnowledge to Wisdom

By definition, an assessment is an evaluation of the patient for the purposes of forming a diagnosis, plan of treatment, and treatment progress. Most assessments measure either functioning or symptom change. The use of functional assessments in behavioral healthcare settings as reliable and valid scientific endeavors began to pick up steam in the 1980s. Today, behavioral health organizations use client-report and clinician-report assessments to diagnose, establish level of care, and monitor client progress over time, while simultaneously responding to federal and state reporting requirements.

The healthcare landscape is moving from a volume-based model to a value-based paradigm, forcing clinicians to improve patient experience and outcomes while controlling the cost of care. Combined with financial data, use of valid and reliable assessments allows facilities to better create, measure and report value in terms of performance, outcomes, efficiency and patient experience.

Organizations interested in improving clinical efficiency and outcomes need not administer a large number of assessments, but rather should:

• Administer reliable and valid assessments • Promote outcome/assessment standardization across their industry to enable community-wide benchmarking and best practices • Use assessments to analyze performance and influence treatment planning and protocols

Netsmart has more than 23,000 client organizations, including more than 450,000 care providers and more than 40 state systems, using our solutions to help improve the quality of life of more than 25 million individuals. That is why at Netsmart we feel it is an opportunity and our obligation to partner with our clients to optimize our solutions for the most efficient and effective use in this ever-changing, rapidly digitizing healthcare landscape. This stands true when one looks at how we aggregate, share and manage our more than 500 clinical assessments.

• Netsmart’s assessments represent a unique combination of standardized assessments and client- developed assessments and questionnaires • The assessments are utilized by some of the most well-respected organizations and clinics, representing a diverse cross-section of the behavioral and mental health community (see list of highlights on back page) • Netsmart assessments are stored in a shareable database, enabling clients to explore these assessments, determine which assessments most closely align with their organization’s needs, and then to select those for implementation into their workflow.

Netsmart is the company able to most effectively support client use of psychometrically sound assessments and customized, client-developed questionnaires to improve care and ultimately treatment outcomes. This is because we offer not only access to a strong list of clinical assessments, but because through its solutions, Netsmart helps clients turn assessment data into meaningful, actionable knowledge.

Enlighten Analytics®Enlighten Analytics is Netsmart’s business intelligence solution, specifically designed for the behavioral health community. Along with financial and operational data, Enlighten captures clinical data – assessment and questionnaire responses– and relates client assessment outcomes to financial and operational (service) data. Employing unique “drill down” capabilities, the information available through Enlighten serves as a road map for the organization, helping to inform care, formulate and ask questions in an ad hoc manner, and evaluate organizational efficiencies. It allows clinicians to leverage assessment data for knowledge-driven care, ultimately leading to more appropriate, person-centric and measurable treatment processes and outcomes.

CareGuidance™CareGuidance is a set of clinical content and decision support tools embedded within our CareRecords™. This content is aligned to the care process and designed to help clinicians achieve desired outcomes. The CareGuidance content includes key structured data from selected standards-based assessments, such as the

Netsmart’s Vision: Building Tomorrow’s Solutions TodayNetsmart is in the position to drive the industry to a new level of care through the use of technologies. Currently, Netsmart is working to further improve the clinical relevancy and effectiveness of our solutions, allowing clinicians to turn the data captured by all of our assessments not only into knowledge, but wisdom that impacts clinical decision making in real-time.

The vision is to continue to build and capture data from a set of standardized assessments and treatment plans, to analyze it and to feed it directly back into our CareRecords. This aggregation, analysis and direct delivery of data from a cloud-based database directly into our solutions would provide effective clinical decision support in real time to clinicians, leading to better informed decisions and improved outcomes.

National Outcomes Measurement System (NOMS) and Child and Adolescent Needs and Strengths (CANS) assessments. CareGuidance has the ability to provide information to clinicians through alerts, notifications, reminders, and access to evidence-based content at the point of action. It likewise provides data and analytical capabilities to measure the use and results of the decision support features.

BenchmarkingCarePathways is Netsmart’s benchmarking solution. While Enlighten Analytics allows organizations to perform sophisticated business analytics on their own data, CarePathways allows clients to compare financial, operational, and clinical Key Performance Indicators (KPIs) against similar organizations. In the clinical realm, this includes assessment outcomes, medication errors, client satisfaction, among many other KPIs. These KPIs and their benchmarks help our clients understand their strengths and opportunities for improvement in treatment and clinical operations. Active benchmarking enhances the quality of care delivered by providing an external standard against which organizations and departments can be compared.

Case study: Adult Needs and Strengths AssessmentThe Adult Needs and Strengths Assessment (ANSA) is a multi-purpose tool developed for behavioral health services to support decision making, including level of care and service planning, to facilitate quality improvement initiatives, and to allow for the monitoring of outcomes of services. The assessment examines life domain functioning, strengths, acculturation, mental health needs and risk behaviors.

Joe Smith walks into Facility X and is administered the ANSA. He is found to have severe anxiety and to be at risk for self-injurious behavior, with few strengths. The clinician determines to provide Joe with cognitive behavioral therapy and to re-assess the client in two months. At the second assessment, the clinician sees that Joe has made strides and his level of anxiety has dropped from a three (most severe) to a two (moderate).

At distinct points in time, Facility X accesses Enlighten Analytics and reviews the data on Joe to see the effectiveness of this type of treatment and how he has fared in relation to similar clients by program, location, and provider. In addition, client outcomes, per program, are compared to similar agencies in Facility X’s state and across the nation and best practices from other leading performer facilities are shared with Facility X. When examined in conjunction with other assessments, interventions and outcomes, the facility is able to determine a set of best treatment practices for Joe and guidelines for improved care organization-wide.

In three months, when Janet Jones walks in with a similar profile, the clinician can use the knowledge from Enlighten Analytics and Benchmarking to support or influence his clinical decision for Janet. Because multiple Netsmart clients use the ANSA, the clinician can also look at what other clinicians using the assessment have done in terms of treatment service visits and see if his outcomes are similar to those other treatment options. The entire process allows clinical staff to refine their service offerings so that care can be more personalized.

500 Assessments & QuestionnairesNetsmart’s assessments and questionnaires represent a diverse cross section between standardized, valid and client-driven assessments. While Netsmart is driving toward greater standardization of data gathering and reporting, we also have the flexibility to work with our clients to meet their unique needs.

ASSESSMENT HIGHLIGHTS: The following is a sampling of Netsmart’s standardized, sharable assessments.

Abnormal Involuntary Movement Scale (AIMS) Neurological Symptoms

Achenback Child Behavior Checklist Results Children

Activities of Daily Living Assessment Functioning

Adaptive Behavior Scale Children

Addiction Severity Index (ASI) Addictions

Adult Needs and Strengths Assessment (ANSA) Functioning

American Society of Addiction Medicine (ASAM) Addictions

Behavior & Emotional Rating Scale (BERS) Children

Behavior and Symptom Identification Scale (BSIS-32) Symptoms

Braden Scale for Predicting Pressure Sore Risk Medical

Brief Psychiatric Rating Scale Adult (BPRS) Symptoms

Child & Adolescent Level of Care Utilization System (CALOCUS) Children

Child and Adolescent Functional Assessment Scale CAFAS® (FAS) Children

Child and Adolescent Needs and Strengths (CANS) Children

Children’s Functional Assessment Rating Scale (CFARS) Children

Clinical Institute Withdrawal Assessment (CIWA) Addictions

Clinical Columbia Suicide Severity Rating Scale (C-SSRS) Addictions

Opiate Withdrawal Scale (COWS) Suicide Risk

Columbia Suicide Severity Rating Scale (C-SSRS) Functioning

Daily Living Assessment (DLA 20) Addictions

Drug Abuse Screening Test (DAST) Functionality

Functional Assessment Rating Scale Florida (FARS) FL - FARS Functionality

Hoosier Assurance Plan Instrument for Adults (HAPI-A) Functioning

Juvenile Inventory for Functioning ®(JIFF) Functioning

Level of Care Utilization System (LOCUS) Other

Mental Health Statistics Improvement Program (MHSIP) Addictions

Michigan Alcohol Screening Test (MAST) Mental Status

Modified Simple Screening Instrument for Substance Abuse (MSSI-SA) Addictions

National Outcomes Measurement System (NOMS) Other

Oklahoma (OK) Teen Addiction Severity Index (T-ASI) Addictions

Patient Health Questionnaire (PHQ - 2) Depression

Patient Health Questionnaire (PHQ - 9) Depression

Preschool & Early Childhood Assessment Scale ® (PECFAS) Children

Substance Abuse Subtle Screening Inventory, Adult– 3 (SASSI-3) Addictions

The Netsmart assessment library has specialized assessments and questionnaires for each of the following states/counties/jurisdictions, among others: Colorado, Florida, Indiana, LA County, Lincoln County, Massachusetts, New York, Ohio, Oklahoma, Tennessee, Texas, West Virginia.