Minimum Data Set for Primary Care – An Old Solution for New Problems Ananda Perera, MD, MBBS, DFM, FCGP (1), D.M.C.S. Jayasundara MD,MBBS, MRCOG (Eng)(2), T.J.S. Peries MBBS (3), A.A.M.M.S.L.Perera MBBS (3) 1) Consultant Family Physician, Councilor BOS/FM PostGraduate Institute of Medicine, University of Colombo, Sri Lanka. 2) Senior Lecturer in Obstetrics and Gynecology University Peradeniya, Consultant obstetrician and gynecologist Teaching Hospital Peradeniya Sri Lanka 3) District General Hospital Negombo Sri Lanka Abstract Minimum data set (MDS) concept is at least 50 yrs old. In fact there already exists a minimum data set proposed for American ambulatory care in 1974. But Family Medicine and primary care medicine has come a long way in terms of content specific research knowledge base since 1974. A MDS for primary care is proposed as a solution for many problems and criticisms leveled against the current implementations of electronic medical records (EMR) in primary care. MDS succintly summarizes the knowledge in terms of collectible data elements. It is but a trivial exercise totally non-technical to convert this MDS into a system specification. This system specification in turn should act as the gold standard against which all the applications are validated. It is more than probable that many causes may underlie the current EMR problems. But MDS offers the best, most feasible and most important of all the most testable solution. Introduction Minimum data set (MDS) concept is at least 50 yrs old (1). In fact there already exists a minimum data set proposed for ambulatory care in 1974 (2). Family Medicine and primary care medicine has come a long way in terms of content specific research knowledge base since 1974. Authors' objectives of the proposed draft is still as valid. More so in the context of new developments in the medical informatics. Among many other things data from primary care will assist patient care, audit, research, administrative and financial functions, education and epidemiology. MDS concept also implies although not explicitly, certain key features which include minimum, standards, agreement, collection and reporting. Arguably, the most important aspect of a MDS is the agreement. Agreement is about the relevance of the domain content and coverage provided by the set to capture at least 80% of morbidity spectrum. This paper presents a proposal for a MDS for electronic medical records in Family Medicine or General Practice or Primary care. The proposed MDS includes data elements covering 10 dimensions spanning the primary care - comprehensive care, continuity of care, coordination of care, patient centeredness, biopsychosocial evaluations, demographic spectrum, morbidity spectrum, patient physician relationships, accountability, primary care clinical method (PCCM). Indicators are proposed relating to each of these dimensions. The choice of dimensions, and their related indicators, has been guided by extensive review of literature, definitions and policy statements proposed and issued by many colleges, authorities and international organizations in primary care, family medicine, general practice or primary care. It is argued that these indicators will provide information which will : a) be feasible to collect given the constraints of primary care practice, b) provide key data relevant to the central policy concerns in the field of primary care, c) and thereby help to improve the performance and quality of primary care systems world over. Before developing each concept in depth, it is useful to summarize the way they relate to each other. Although these 10 dimensions collected together may look so disparate there is an overarching current of underlying thoughts. Taken together they build up a logical model of primary care delivery. MDS captures the critical elements required for the logical flow of events and objects in the enactment of primary care delivery. Almost all of these dimensions of primary care are immediately understandable and yet open to multiple interpretations and misinterpretations. And indeed there is much confusion and chaos about so very fundamental aspects of the specialty. To clear the confusions it must be mentioned at this very early stage that the terms "Primary Care", "Family Medicine" and "General Practice" are used synonymously. The existing nuances of meaning and conceptual overlaps are irrelevant for the current objectives. The foundation on which the primary care delivery based on is the comprehensive care. A new entrant to