Sunday, February 28, 2010

MLB instituting new medical records system

From the moment a player joins any organization in Major League Baseball, his baseball vital signs are well documented. With radar-gun readings, scouting reports and countless game statistics seemingly charting his every move, there's literally a book on every professional player.

For a trainer, the medical book needed on a player hasn't always been as accessible or as thorough, his vital signs sometimes harder to read.

But that is changing in 2010, with Major League Baseball instituting through all 30 organizations a new integrated, Web-based system designed to allow trainers to have more and better medical information at their fingertips.

"In 2020 or even 2015, I think there'll be people looking back saying, 'What's remarkable is you used to do it any other way,'" said Stan Conte, the Dodgers' director of medical services and head trainer.

Conte was among the Major League trainers instrumental in pushing for such a system in order to streamline access to injury and treatment information, both internally and when players move from one organization to another, and ultimately to perform Job One when it comes to athletic trainers' mission: providing the best possible care for players.

"What makes it new and exciting to those of us in the field is the continuity of care," Conte said. "I've always said the medical department is not the baseball department. When a player comes to your team, you're responsible for them and their medical care."

For years, Conte and other members of the Professional Baseball Athletic Trainers Society (PBATS) lobbied for a system that would make that job more efficient. After all, waiting 2-3 days for medical records following a trade or having too many hurdles trying to keep tabs on the hundreds of players in their own organizations was so ... Y2K.

In the span of a little more than a year, their wish was granted. Starting this Spring Training, baseball's trainers and doctors have a new tool at their disposal that eventually will provide an encyclopedia of knowledge on every professional player. It's much like one being used in the National Hockey League the last three seasons, and like the NHL one designed by SuttonMed Systems, but customized to fit baseball's specific injury dynamic.

With discussions beginning in 2007 and the project starting in earnest following what Conte described as a turning point at the 2008 Winter Meetings, Major League Baseball's labor relations department made the system a high priority.

"It obviously doesn't appear out of nowhere. It's something that's been discussed for a number of years, and any project of this magnitude takes time," said Dan Halem, senior vice president for labor relations for Major League Baseball. "But we got there."

Even Conte was pleasantly surprised when the system went online for all 30 clubs as of Jan. 4. "When they first said it'd be ready for 2010, I said there's just no way," he said.

The system, which Halem said does not change any rights of players in the Collective Bargaining Agreement, is still in the early stages of getting up and running, with previous records being digitized and training staffs documenting Spring Training treatment in the system in real time. Conte and Halem say there is a lot of growing into it to be done, and no doubt a lot of adjustments to be made.

"Right now, we're focused on getting the system rolled out to 30 clubs," Halem said. "It's a very large undertaking. This year is almost a test year, and it's going to need to be upgraded based on feedback. But every player on every club at every level down to Rookie ball will have their records in this new system."

It's a step forward, all would agree. Going from a number of different approaches with different sets of records and a lot of manual file-keeping to a fully digitized and standardized, eminently secure and state-of-the-art system that's being put into effect industry-wide in the span of about a year? That's significant progress.

As Halem suggests, it didn't happen in a vacuum -- or without a lot of work. MLB director of labor relations Chris Marinak made the project his mission, spearheading the efforts of customizing it to meet the specific needs of baseball, and ensuring it will be the benefit sought for 30 teams.

"The goal was to implement the best medical electronic system being used in professional sports, and we should be able to get there," Marinak said.

In some respects, the process of getting the system running was a logical exercise -- baseball players' injuries are often related to the elbow or shoulder, as opposed to the many knee injuries or concussions one might see in the NHL or the National Football League, which also has a database system. So the system is set up with categories that make sense for baseball.

But there of course have been and will be variables involved.

"It's very complicated," said Marinak, who said it took about six months of "architecting it out" to get the system to the point where training staffs could move into their record-keeping houses this year. "There's no one generally acceptable way for providing treatment for certain injuries, so there was a lot of discussion about how to approach that sort of issue and make the system operate in such a way that medical staffs can best track and record injuries and treatments."

The system, which also will be used for Major League umpires, is secure with tracking of access, which is limited to specific personnel within an organization. With it, Conte can remain totally apprised of a Double-A second baseman's injury progress, and a general manager can track reports from a pitcher's Minor League rehab assignment in real time. Where there used to be stacks and cabinets of files, there will be digital access to magnetic resonance imaging (MRI) scans, X-rays, reports and any other records. And, unlike in the past, there will be standardization, which will aid in team medical staffs knowing the history of a player arriving via trade or Minor League or Major League free agency.

"One of the things that's going to happen with this system is that everybody's going to be speaking the same language," Conte said.

Security is of obvious importance, and obvious priority. While, for instance, Dr. Lewis Yocum or Dr. James Andrews, noted surgeons who perform procedures on players from many teams, might have limited access to records to help them treat players, access is extremely limited in general. No, the Red Sox can't check out the Yankees' medical records, or vice versa. And, no, fantasy baseball owners can't get a leg up on their players' latest medical reports.

Like any one being treated medically would expect, this information is protected by federal HIPAA privacy guidelines and expected to be in even better hands now.

"The information here is more secure than it's ever been," Conte said.

Halem said the future could include some element of predictability, based on years of injuries and treatments being documented. While injury predictability using sabermetric algorithms and other research has been one of Conte's own projects in recent years, that's not what piques his interest here.

As a trainer, Conte is excited about the system for one reason.

"This is going to make things a lot easier in terms of taking care of the medical needs of players," he said.

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