2. The data base for rehabilitation services

Rehabilitation is a long-term multidisciplinary, and outcome-oriented process, which requires a more complex data base than one derived from a strictly medical model of diagnosis, treatment, and cure. The rehabilitation data base must document need and potential for benefit, reasons for encounter, intensity of services, response to services in terms of outcome and durability of rehabilitation, and significant modifiers related to the individual and his environment that affect intake, outcome, and follow-through. Research has shown the potential value of functional indices as components of this data base and has illustrated approaches to their validation. A central question is whether a data base designed for patient care can also have utility for institutional management and policy formulation in view of differences in content, level of detail, and timing. Other problems that have become obvious in the past decade of experimentation at the Texas Institute for Rehabilitation and Research include the burden of data collection on professional and technical staff, cost effectiveness of data systems, validity and reliability, too much or irrelevant data in the system, and behavioral obstacles to new systems and their effective use. Despite these problems, multilevel information systems that can be expanded or contracted in detail and are designed to provide data of established utility are clearly needed in rehabilitation.