Insurance companies, managed care organizations and patient advocacy groups are increasingly interested in outcomes data. That is why the Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS) program, is expected to be an indispensable tool for doctors.
"MODEMS provides an opportunity to demonstrate quality of orthopaedic care as measured by patient outcome to the benefit of doctors and the improvement of quality care," said Joseph A. Buckwalter, MD, chairman of the MODEMS Task Force on Data Management.
MODEMS is a project of the Academy, Council of Musculoskeletal Specialty Societies (COMSS) and the Council of Spine Societies (COSS). The evolution of the Academy's involvement began with the Musculoskeletal Outcomes Research Symposium in 1990. The Academy's Board of Directors approved a $455,000 development program and pilot test in early 1995 and gave the green light to the project early in 1996 with a commitment of $1.1 million.
Up and running since November 1996, MODEMS offers orthopaedic surgeons the ability to evaluate and document the outcomes of the musculoskeletal care they offer their patients and the effect of cost-containment methods.
MODEMS enables practitioners to compare their outcomes to a national database. It also gives the profession a clearer view of what treatments work and what doesn't from data that comes from the practitioner.
The data collected and stored by the practitioner also can be used for his or her additional research. The data submitted to the national data base is owned by the MODEMS Task Force on Data Management.
Eleven outcomes data collection instruments have been developed by the MODEMS task force for Lower Limb; Arm, Shoulder and Hand; Spine; and Pediatrics. The instruments contain a current health assessment followed by questions focused on functional ability related to specific anatomic areas. For instance, the spine instrument includes a current health assessment, lumbar module, cervical module and scoliosis module. The questionnaires are structured so the patient only has to either circle a response or check a box next to a response.
"In the future, we hope to refine the instruments to make them smaller and we need follow-up instruments," Dr. Buckwalter said. "We have to make the information-gathering part of the patient flow and to make the data entry a patient task, not an office task."
With little more to go on than progress reports in the Bulletin and other Academy publications and an initial marketing effort, more than 50 orthopaedic practices had subscribed to MODEMS by late November. An expanded marketing program is now being planned which is expected to attract many more subscribers.
Dr. Buckwalter said two specialty organizations and a state organization are interested in participating in the MODEMS project.
A subscriber can be a physician group, hospital, health care facility, health maintenance organization or other entity in which or through which an individual orthopaedic surgeon practices. A practitioner must be a resident member, candidate member, fellow or emeritus fellow of the Academy or in an equivalent category in any member society of COMSS or COSS.
A MODEMS subscriber receives training on the operation of the software, instruction in the selection of patients to follow, administration of the questionnaires, transmission of data, analysis of the data collected by the practitioner and interpretation of the data from the national database.
The practitioner receives reports at least annually on the contents of the data base on hard copy or on computer disk.
A MODEMS subscriber pays a one-time $500 fee to initialize the database and an annual fee of $500 for each participating practitioner affiliated with the subscriber. Subscribers also will purchase software from one of several vendors certified by the Academy.
A videotape explaining the importance of outcomes data collection and how it can be used to improve patient care videotape will be sent to potential subscribers who express interest in using MODEMS.