What is MDS?

SriggRN320 gave you an excellent concise overview of MDS from the nursing prospective. I am a student of Health Information Management (was called Medical Records in your day) and can also tell you that MDS information is sent to Medicare electronically (by computer). Besides being used to determine how much Medicare and state Medicaid is going to pay nursing homes for each patient, the demographic information of all LTC patients is entered into a huge database maintained by CMS (Centers for Medicare & Medicaid Services, formerly called Health Care Financing Administration the father of Social Security) maintained by the federal government. They are making this database available to all kinds of healthcare users (research, management, etc.) The term for this is informatics. Analysts look for all kinds of trends by patient diagnosis, age, sex, geographic area, and on and on (there's like a list of 20 or more categories of data they can look at, compare, and merge together to create all kinds of reports). There are a number of different healthcare facility types that are required to submit data to CMS. Nursing homes and long term care facilities who submit MDSs are only one group. You may be familiar with the term DRGs (Diagnosis Related Groups) which is another required reporting group. It is for acute hospital patients and one way Medicare uses DRG information is to determine how much a hospital is going to be paid for each Medicare patient based on the diagnosis group(s) he/she fits in to. Most recently, outpatient surgical care centers were added to this list of required reporters. I believe that the next targeted group is the Outpatient Ambulatory Centers. The plan is to eventually have data submitted to the federal government for just about every patient encounter that occurs in this country. The idea is, as I said above, to look for trends as well as to help develop efficient and effective standard treatment pathways.

Very sophisticated computer systems are required to do this. Currently, the American College of Surgeons owns and continues to develop a coding system called SNOMED (Systematic Nomenclature of Medicine and Veterinary Medicine) which has the ability to classify diseases and medical conditions, by computer designated codes, which are complex and longer in length than the current ICD-9-CM diagnosis codes and CPT codes in use in the United States. ICD-9-CM and CPT codes are most commonly used by healthcare facilities in their billing process, but they are also used for many, many other computer applications. ICD-9, the "father" of ICD-9-CM, is owned by the World Health Organization and used by them to compile and report world-wide mortality and morbidity figures. Some acute hospital computers are already attaching SNOMED codes to patient charts. And, just a little info here, NANDA has merged their nursing diagnoses with SNOMED.

And just to throw in a little bone for all you still reading this. . .the plan for the future is that each American not only have a social security number but our own individual, unique medical record number as well. The plan is for each of us to have our own electronic chart kept in a massive database and identified by that unique medical record number.

Whew! This stuff intrigues me and is one of the reasons I am changing stream a bit and studying it. The day of the computer is here and this stuff is BIG. I guess it was bound to develop eventually. Want to know where it started? Great Britain. They developed medical coding to track what was going on within their national health care system. Canada, France and the U.S. got on board and look how it took off. Any doubt that the federal government doesn't have a hand in U.S. healthcare or that George Orwell wasn't wrong about Big Brother? Now, take out a piece of paper for a little quiz. Ha! Ha! :rotfl: