Although there are dozens of iterations or applications of FIT, the top three most popular evidence-based programs which are interfaced (or being interfaced) with Kipu EMR are:
Evidence-Based Programs Pre-Loaded in Kipu
- BAM - The Brief Addiction Monitor Introduced in 2009 for standardized use in the VA Health System and rolled out to all 46 VA hospitals who treat SUD. 17 questions take less than two minutes per use, measuring how the patient is doing in treatment and later post-treatment, such as: risk factors, protective factors, and drug/alcohol use.
- ORS - Outcomes Rating Scale SRS - Session Rating Scale Already used with hundreds of thousands of patients, this simple four-question ORS scale measures patients’ well being in his or her lifestyle balance in the areas of individual, interpersonal, and social functional. The SRS measures the therapeutic alliance between therapist and patient.
Don’t forget, Kipu makes it super easy to create, test, and modify your own, or incorporate additional questions into the above tools for additional data points.
1 - Brief Addiction Monitor
The primary purpose of the Brief Addiction Monitor (BAM) is to support individualized, measurement-based care for substance abuse disorders (SUD). The BAM monitors a patient’s progress in SUD care and yields reliable data that is both easy to collect and readily integrated into SUD treatment planning. The BAM is a 17-item, multidimensional questionnaire administered electronically from Kipu EMR to patients seeking or enrolled in SUD specialty care. It retrospectively assesses three SUD-related domains: Risk factors for substance use, Protective factors that support sobriety,and drug and alcohol use.
Items were selected for inclusion in the BAM based on their presence in existing SUD measures and/or on empirical support for their reliable and valid assessment of SUD relapse risk and treatment outcome. Each item ranges in value from zero to 30, the Use Score ranges from zero to 90, and the Risk and Protective factor scores range from zero to 180. Two studies have been done on the psychometric properties of the BAM. One of the first studies made use of the continuous item version of the BAM. This study found support for the factor structure, internal consistency, test-retest reliability, and sensitivity to change of the BAM. BAM scores collected at intake also predicted treatment completion vs. dropout.
In another study, BAM scores obtained weekly from a smartphone application over an 8-month period significantly predicted relapse status within the week following the assessment. End-users are strongly encouraged to attend the item-level data rather than the three factor scores) because they have direct implications for treatment planning. That is, they identify specific areas of need or resources the patient brings to bear in his/her recovery.
2 - Outcomes Rating Scale (ORS)
Session Rating Scale (SRS)
Group Session Rating Scale (GSRS)
The ORS, SRS, and GSPS are each four-item measures designed to track treatment progress and therapeutic alliance, respectively. The ORS is administered at the start of each therapy session or week, and is scored and reviewed with the patient in the session or week; the SRS or GSRS for group sessions is given at the end of each session and is reviewed as any concerns arise. The ORS measures overall functioning as well as individual, interpersonal, and social functioning, whereas the SRS assesses the patient’s feelings about the therapeutic relationship, goals and topics, and approach/method, as well as overall satisfaction with the session just completed.
Validity research on the ORS was conducted in a community family service agency in South Florida, with an adult clinical sample comprised of two-thirds women, of unknown ethnicity. A further validation study included a large ethnically diverse sample, again two-thirds woman, from an international employee assistance program. The SRS was initially validated on samples from three different clinical sites, an outpatient mental health counseling agency in Connecticut, as well as a community family service agency, and has since been implemented in many other SUD treatment programs. Research in an array of settings, including individual therapy and couples therapy, indicates that treatment incorporating these measures results in greater client improvement, at a faster rate