Reducing Adolescent Substance Abuse Initiative

Guidance for DataCollectionand Reporting

Contents

I.Introduction

II.Target Population for Screenings and Treatment

III.Microsoft Access Database

IV.Entering Patient Information into the RASAI Data Collection Form

a)Form Actions:

b)Report Actions:

c)Personal Information

d)Behavioral Diagnosis Information

e)Patient Screening Information: Initial Screening Information and Actions Taken

f)Patient Screening Information: Follow Up Screening Information

g)Other Functions

V.Other Database Information

a)Transferring the Data in the Database

VI.Office Workflow

VII.Disenrollment

VIII.Report Submissions

IX.KeyContacts

X.Data Collection Form

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I.Introduction

This guidance is for participants of the Reducing Adolescent Substance Abuse Initiative.

The goal of clinical data reporting for RASAI sites is to learn more about: the young people we serve, SBIRT’s effectiveness in community behavioral health settings, and the challenges and successes of SBIRT implementation. To meet that goal, sites will track and report a small number of at the patient level, using standard indicators across all RASAI sites.

This guidance is designed for sites using paper forms and the RASAI database for data collection and submission.

FOR THOSE USING ELECTRONIC HEALTH RECORDS

If you are using your Electronic Health Records, there may be limits to what you can collect. For instance, standard EHRs do not collect “transgender” as a gender and have different responses for “smoking status.” If there is variance among what your EHR collects and our data form, that is completely fine. Those using certified EHRs should continue to follow the national data standards in data collection and reporting, using the paper-based form for guidance on the nature of data to be collected, and the Excel spreadsheet as the format for data submission. Data leads should have received the Excel spreadsheet via email, but if not, please visit the Data Lead section of the File sharing website: assistance related to collecting RASAI data in your organization’s EHR, please contact Colleen O’Donnell at or 202-684-7457 X278. Colleen has also prepared an EHR FAQ document for your use.

II.Target Population for Screenings and Treatment

Screeningsshouldbeadministeredtothe clients who participate in the programs you have selected for RASAI.

  • Datashouldbecollectedand entered into the database fromallpatients in the programs that you have selected.
  • Datacollection and submittalshouldnotbelimitedto any certain population or group, except for cases when programs serve both adults 23 and older and individuals 22 and under. In that case, only collect and submit data for individuals 22 and under.
  • Datashouldnotbesubmittedforpatientsseenoutsideofthescopeofthisproject.

III.Microsoft Access Database

The Access Database is intended to be updated by one user at each participant site. Download the database and save it in a place that is secure.

  • Click File, select “Save As,” and make sure that “Save Database As” is highlighted in pink, then click the “Save As” icon on the center of the screen to save the database to your desired location.

IV.Entering Patient Information into the RASAI Data Collection Form

Ascreenshot of the data submissionformisincludedinSectionX. Brief instructions for using the data submission form are also located on the Access Data Collection Form.

Note: The form opens on an already existing patient record.

a)Form Actions:

Form buttons are located across the top of the form to help users select their preferred database form actions.

  • Add New Patient: Click this button for a new record to appear, which will allow users to add information on a new patient.
  • Find Patient’s Record: Click this button to find an existing patient’s information.
  • To search in a particular field, click the field desired and then click the “Find Patient’s Record” button. Enter whatever information you are searching for.
  • To search in all fields, select “Current Document” from the dropdown menu located to the right of “Look In:”
  • Next Record: This button allows you to manually search for records by clicking until you find the right patient.
  • Previous Record: This button allows you to manually search for records by clicking until you find the right patient.
  • Refresh: This button allows you to refresh the data in the database to immediately show updates made.

b)Report Actions:

Report buttons are located across the top of the form to help users run needed reports.

  • Export Quarterly Report:This button allows you to export de-identified data directly into reports to be submitted quarterly.
  • Export Quarterly Report with Names: This button performs the same function as above but also included participants’ names.
  • Export Anticipated Follow Up Date Report: This button allows you export a report of Anticipated Follow Up dates based on the date range you enter. The report will pull all Anticipated Follow Up dates that fall into that range.

c)Personal Information

This section is where personal information for each patient is entered. It is the information that is captured on the Data Collection Sheet in the “Patient Information” section.

  • Patient ID Number:This number is automatically generated for each new patient. It is used to track patients in the database and to export the de-identified data.
  • PatientName:Type in the patient’s first and last name.
  • Date of Birth: Type in or select the patient’s date of birth.
  • Screening Date:Thisisthedatethattheinformationiscollectedorthepatientisscreened (evenifthedataisenteredintothedatabaseat alaterdate).Thisdatewill beusedtodetermine“NextAssessmentDate”. Select or enter this date into the database.
  • Patient Record Number: Type in patient’s record number. This is optional.
  • Ethnicity: Select from dropdown list.
  • Race:Select from dropdown list.
  • Gender Identity:Select from dropdown list.
  • Smoking:Select from dropdown list.
  • Never smoked
  • Currenteverydaysmoker(atrisk)
  • Currentsomedaysmoker(atrisk)
  • Formersmoker
  • Delete Patient: This button allows you to delete a patient from the database. A prompt will ask you if you are sure you want to delete the patient.

d)Behavioral Diagnosis Information

This section is where information about patient’s behavioral health is entered. It is the information that is captured on the Data Collection Sheet in the “Patient Information” section.

Note: Enter the Diagnosis Code of the Behavioral Health Diagnosis (primary only).

  • Diagnosis Code: Type in either DSM (4R or 5 is permissible)or ICD-9 diagnosis code.
  • Behavioral Health Diagnosis: Select from dropdown menu.
  • Behavioral Health Something Else: If patient’s diagnosis is “Something Else,” type it in here.

e)Patient Screening Information: Initial Screening Information and Actions Taken

This is section is where the clinical indicators for each patient are entered along with the “Actions Taken” section from the Data Collection Sheet.

This section is located in a box with two tabs, and this is the first tab titled, “Initial Screening Information and Actions Taken.”

  • Alcohol Use Score:Type in score.
  • Drug Use Score: Type in score.
  • CRAFFT Score:If CRAFFT is used, type in score.
  • UNCOPE Score:If UNCOPE is used, type in score.
  • Score warrants Brief Intervention (BI) or Referral to Treatment (RT): Select Yes or No from dropdown menu.
  • Score warrants BI or RT, but not pursued: Select from the dropdown menu.
  • Brief Intervention 1 Date: Select or type in date.
  • Brief Intervention 2 Date: Select or type in date.
  • Brief Intervention 3 Date: Select or type in date.
  • Brief Intervention 4 Date: Select or type in date.
  • Patient was referred to treatment: Select from the dropdown menu.
  • Date patient was referred to treatment: Select or type in date.
  • Patient attended treatment: Select from the dropdown menu.
  • Date patient attended treatment: Select or type in date.
  • Anticipated Date of Follow Up Screening: Select or type in date.

f)Patient Screening Information: Follow Up Screening Information

This section is where the follow screening information is entered for each patient. This information can be found on the Data Collection Sheet under the “Actions Taken” section and the “Follow Up Screening” section.

This section is located in a box with two tabs, and this is the second tab titled, “Follow Up Screening Information.”

  • Actual Date of Follow Up Screening:Select or type in the follow up screening date.
  • Follow Up Alcohol Score: Type in the score.
  • Follow Up Drug Use Score: Type in the score.
  • Follow Up CRAFFT Score: If CRAFFT is used, type in the score.
  • Follow Up UNCOPE Score: If UNCOPE is used, type in the score.

g)Other Functions

This section includes buttons to perform less frequent database actions.

  • Open Datasheet: This button allows you to open the data spreadsheet, where you can directly edit or enter the data without the form if preferred.
  • Export Datasheet:This button allows you to export all of the data in the database into an Excel file.

V.Other Database Information

a)Hiding the ribbon (tool bar) at the top of the database for a cleaner look

If you would like to hide the ribbon at the top of the database, please follow the directions below.

  • There is an arrow at the far right of the page, in the bottom right corner of the ribbon.
  • Click the arrow to hide the ribbon.

b)Replacing the ribbon (tool bar) at the top of the database

To put the ribbon back in place, follow these directions.

  • Click the “Home” tab at the top left of the page.
  • A pushpin will appear at the bottom right corner of the ribbon.
  • Push the pin to pin the ribbon back in place.

c)Transferring the Data in the Database

If something goes wrong with the database and the data needs to be extracted and put into a new database, please follow the instructions below.

  • Download the new database to your computer.
  • Open the original database and the data collection form will open.
  • At the bottom, select “Open Datasheet” under “Other Functions.”
  • When the datasheet opens, select “External Data” at the top of the database.

  • To the right, in the “Export” section, click “Access” at the top right.
  • A window will prompt you to browse for the new database.
  • Select the new database and click “Ok.”
  • A window will open asking where to export the data, leave all the selections as they are, and click “Ok.”

  • Click close, then open your new database.

VI.Office Workflow

The recommended workflow, for those using the paper version of the data collection form, is to have the clinician hold onto the form until the ‘Actions Taken’ section is complete (except for the ‘Actual data of follow up screening’). At this point, the clinician should give the form to the data lead to be entered into the database. Once the form has been entered into the database, the form should go back to the clinician so they can collect the follow up screen information. Once the follow up information has been entered, the form should go back to the data lead to enter the follow up information into the original entry for that consumer. At this point, data entry is complete for that consumer.

VII.Disenrollment

It is unnecessary to use the Data Collection Form to designate when someone has disenrolled from your program or stopped attending your agency. This information is unnecessary for RASAI purposes.

VIII.Report Submissions

Data extracts with de-identified patients data should be submitted by the fifteenth of every month (or the following business day if the 15th falls on a week or holiday) to:

  • Aaron Surma,
  • Jake Bowling,

IX.KeyContacts

Aaron Surma, MSW

Quality Improvement Associate

(248) 345-6535

Jake Bowling, MSW

Director, Practice Improvement

(202) 684-7457

X.Data Collection Form

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