June 1998 Bulletin

MODEMS database needs everyone’s active support

Wouldn't it be great if we had a national database of normative information about the clinical outcomes of the treatment of patients with musculoskeletal conditions? Wouldn't it be particularly exciting if that database were very large, representative of patients of all socioeconomic classes treated by a wide variety of musculoskeletal care providers and not influenced by commercial interests?

I could use that database to compare my ability to manage a particular musculoskeletal condition with the outcomes of my colleagues locally or nationally. I also could provide that data to managed care organizations and other third party carriers interested in knowing that the patients they are insuring would receive quality care in my hands. With such information accessible only to me, I could identify my areas of clinical weakness or under-performance when compared to national benchmarks. This knowledge could help me tailor my continuing education to improve the quality of care I provide my patients.

To achieve these objectives, your Academy has made a commitment to develop such a database. The actions of the Task Force on Data Management during the last two years have led to the development of the Academy's forward-thinking, standard-setting clinical outcomes research program, now known
as MODEMS(™). It uses standardized, patient-based questionnaires to collect information about functional outcomes. The information, collected either electronically or on paper, is transmitted to the centralized, secure, national database, where it can be analyzed and reports generated.

Your Board of Directors at its December 1997 meeting recommended the creation of a separate not-for-profit corporation called the Musculoskeletal Education and Research Institute and committed $1 million of our reserves to fund its operation over the next two years. This Institute will promulgate outcomes instruments, collate the information derived from those instruments and provide useful feedback to the individual practitioner. It will be a broad-based organization comprised of individuals from within and outside orthopaedic surgery. Your Board of Directors has made a strong commitment to this initiative, hoping that within the next two years the outcomes database will be sufficiently large to provide useful information about many musculoskeletal conditions.

To date we have not recruited enough practices or individual practitioners to participate in the development of the database. One of the major stumbling blocks has been the substantial time and expense to purchase computer hardware and software to implement the MODEMS program, combined with the need to identify personnel in the office to enter the data appropriately. Recently, the Academy has solved this issue by offering a new software product, Passport(™), that is easy to use, very reasonably priced and operates in a Windows 95 PC environment. It enables you to start data collection as soon as you become a MODEMS subscriber.

During this coming year, we are going to encourage all of the orthopaedic specialty societies, through the Council on Musculoskeletal Specialty Societies, to become actively involved in the collection of patient information for this very important database, each in its own special area. It is our sincere hope that during the next 18 months, we will accumulate enough information to provide a really valuable resource to each and every one of us actively engaged in the practice of orthopaedics. I encourage your individual participation as well, and if there are specific questions or specific roadblocks or problems that you encounter, I would love to hear about them personally. Once the database is in place, we will have an invaluable resource to aid our care of patients, to improve our positions in the marketplace and to enhance our ability to design our own personal continuing education program.

James D. Heckman, MD

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