DISEASE MANAGEMENT
Disease management is defined as "a system of coordinated health care interventions
and communications for populations with conditions in which patient self-care efforts
are significant". It is the process of reducing healthcare costs and/or improving
quality of life for individuals by preventing or minimizing the effects of a disease,
usually a chronic condition, through integrative care.
Disease management has evolved from managed care, specialty capitation, and health
service demand management, and refers to the processes and people concerned with
improving or maintaining health in large populations. It is concerned with common
chronic illnesses, and the reduction of future complications associated with those
diseases.
Disease Management includes
- Coronary heart disease
- Chronic obstructive pulmonary disease (COPD)
- Kidney failure
- Hypertension
- Heart failure
- Obesity
- Diabetes mellitus
- Asthma
- Cancer
- Arthritis
- Clinical depression
- Sleep apnea
- Osteoporosis
- Other common ailments
Disease Management Process
The underlying premise of disease management is that when the right tools - experts,
and equipment are applied to a population, then labor costs (specifically: absenteeism,
presenteeism, and direct insurance expenses) can be minimized in the near term,
or resources can be provided more efficiently. The general idea is to ease the disease
path, rather than cure the disease. Improving quality and activities for daily living
are first and foremost. Improving cost, in some programs, is a necessary component,
as well. However, some disease management systems believe that reductions in longer
term problems may not be measureable today, but may warrant continuation of disease
management programs until better data is available in 10–20 years. Most disease
management vendors offer return on investment (ROI) for their programs, although
over the years there have been dozens of ways to measure ROI. Responding to this
inconsistency, an industry trade association, the Care Continuum Alliance, convened
industry leaders to develop consensus guidelines for measuring clinical and financial
outcomes in disease management, wellness and other population-based programs. Contributing
to the work were public and private health and quality organizations, including
the federal Agency for Healthcare Research and Quality, the National Committee for
Quality Assurance, URAC, and the Joint Commission. The project produced the first
volume of a now four-volume Outcomes Guidelines Report, which details industry-consensus
approaches to measuring outcomes.
Disease Management Tools
- Web-based assessment tools
- Clinical guidelines
- Health risk assessments
- Outbound and inbound call-center-based triage
- Best practices
- Formularies
- Numerous other devices, systems and protocols
Disease Management Experts
- Actuaries
- Physicians
- Medical economists
- Nurses
- Nutritionists
- Physical therapists
- Statisticians
- Epidemiologists
- Human resources professionals
Disease Management Equipments
- Mailing systems
- Web-based applications (with or without interactive modes)
- Monitoring devices
- Telephonic systems