Disease management or DSM (disease state management) is a new buzzword in health care. You might also hear it referred to as: disease state modeling, outcomes management, population-based care management or care mapping. It isn't really new, but the amount of attention paid to it is.
In general, it is identifying populations (patients) with acute and chronic diseases and introducing interventions throughout the lifecycle of the disease which will both improve the quality of life, along with lowering costs associated with the disease process. For example, people with certain disease conditions or a common diagnosis have a higher probability of needing recurring and costly admissions to the Emergency Department or a hospital.
In addition, the outcomes of the interventions are scrutinized via measurement and research to ensure the approach is making a positive impact -- on both quality of life and in lowering cost.
Many involved in health care are looking at or developing DSM programs -- pharmaceutical companies, insurance companies, physicians, nurses and healthcare systems. Why? Because in an environment of managed care, the whole aim of healthcare is to keep people out of the hospital and emergency departments. For those patients already hospitalized or in long-term care facilities, special programs are developed to decrease the severity of the disease and enhance activities of daily living.
There is a fury to get aboard the DSM wagon. The bottom line is that in areas heavily penetrated by managed care -- health care systems, physicians and insurance companies make money by keeping people healthy and outpatients (versus inpatient hospitalizations), or by decreasing the length of their stay if they need to be admitted.
If done correctly, DSM can be of benefit to both the patient and healthcare provider. Patients and families must be given information to understand their illness along with self-care strategies that optimize all resources. DSM also usually includes encouraging compliance with a prescribed medical and/or nursing regimen. The challenge is ensuring the patient and family agree with and accept the path to optimal wellness - either while an inpatient or at home.
This can be contrasted with 'disease prevention' or 'health management' that focuses heavily on the prevention of the disease process before it occurs.
Why does this information exist on a site devoted to Telephone Nursing?
Where Telephone Triage Nurses use symptom-based algorithms or protocols, DSM programs may use critical treatment pathways or algorithms related to diagnostic conditions. Both use medically approved guidelines and are supportive of medical regimens. Both focus strongly on education provided by a nurse as a tool to give patients control of their health and self care options. Both may use the telephone to help a person and family work toward quality health. Rather than reinventing the wheel, pre-existing Telephone Nursing Call Centers can be refocused to disease management objectives after additional staffing (sometimes specialized nurses), education and tools are added. Both are examples where appropriate education and a caring attitude by nursing professionals can make a major impact on the health of all patients.
Development of Disease Specific Outcomes Instruments Disease Management - A Better Alternative to the Managed Care Process Disease Management - An End Stage Model Disease Management Evolution
Disease Management - Infections in Long-Term Care Computer World Article on DM "Disease Management" - Newest Buzzwords in Managed Care Disease Management Shows Great Promise Journal of Pharmeceutical Care Managed HealthCare Magazine Medical Marketing and Media Outcomes Measurement and Management Psychotherapy Finances - Niche Marketing US Disease Management on Way to Canada
CareMark Cedars-Sinai Medical Center CMSA Oncology Forum CIBA - Switzerland CR Bard Disease Management Forum Eli Lilly and Company Express Scripts Florida Hospital and Eli Lily Team Health Protection Inc. Innovation - Disease
Management LifeWay Memorial Sloane-Kettering DM National Jewish New England Medical Center DSM NetForce Incorporated NovaFactoRx NYLCare Health Plans has a state-of-the-art disease management program for plan members with Congestive Heart Failure (CHF). The web site states they are partnering with Stuart Disease Management Services, based in Wilmington, Delaware. They also have an asthma program that uses licensed respiratory therapists
who visit NYLCare members in their homes.
Olsten HealthCare Optum's Disease Management Program PCS Health Systems
Prescriptive Analysis Inc. Sage Disease Management Systems - SAGE Sterling HealthCare Outcomes (SHO) US HealthCare Special Programs Vision Care Disease Management
None listed at present
Disease Management and Clinical Outcomes Journal Disease Management and Health Outcomes Drug Outcomes Sourcebook [$] Heart Disease Management [$]
Cancer and Heart Agenda Cochrane Collaboration Dementia - Management Guidelines Health Outcomes Information Health Services/Technology Assessment Text (HSTAT) Medical Matrix Medical Outcomes Trust
The webmaster of Webster's Telephone Triage Nursing website
Copyright © Kathi Webster, 1996, 1997. All rights reserved.
What is It?
Disease Management Articles/News
A text file prepared by Michael Steward MD and edited by Carl Slater MD. Helpful to anyone looking at approaches to outcome measurement.
Article by Kent Giles MPPM related to onocology and disease management at the Association of Community Cancer Centers web site. Interesting viewpoint.
From JWG Kistemaker in October 1995, found at the CBOsite or Centraal Begeleidingsorgaan, the National Organization for Quality Assurance in Hospitals in the Netherlands. There are other interesting articles here on health outcomes and quality improvement.
Article by Matthew Weiner PharmD for the PharmaTech web site. Focus on drug therapy.
Information about a session on this topic by the American Society of Consultant Pharmacists at their 26th Annual Meeting in Nov 1995.
"Disease Management Comes to IS" is the title of this article by Linda Wilson in the 11/27/95 issue of Computer World.
Article in the Managed Care News section of Vital Signs from the Massachusetts Medical Society.
An item at Medical Source that focusing on "who's doing it" and "DSM's Greatest Hits".
The role and economic impact of pharmeceutical care
Online magazine has a section on DSM under "HOT TOPICS"
Article entitled "Disease Management Good Therapy for an Ailing Industry?"
By David Aquilla and Patty Ball at Velocity HealthCare Informatics Inc.. Other relevant articles are available at the same website.
Article on "Finding a role for therapists in disease management".
News on the Canada Newswire
Disease Management on the Internet
Information about the CareMark Corporation - see their Disease Management section.
The health delivery research arm of Cedars-Sinai called HSR has a strong interest in patient outcomes research and clinical practice guidelines. Worth a tour through this web site.
Disease State Management Forum where you can communicate with the disease state management experts of Chemolab, as well as other case managers. Also includes a DSM library and resource area. Chat areas not very active, but has nice possibilities.
Has a disease management program called Customer-Guard using telemedicine to improve the health status of clients with asthma and cardiac problems.
News release on Bard's disease state management strategy dated 4/17/97
Sponsored by Greenstone Health Solutions, this is a web based discussion forum, and events calendar. Greenstone itself is a disease management company.
Pharmeceutical company establishes a disease-management subsidiary. Their web site also includes info on their international disease prevention and management programs.
Pharmacy benefit manager company developing disease management services.
Disease-Management Information System at Disney's Town of Celebration
Diabetes focused disease management program. Includes info on the program plus one year medical outcomes.
From the Diabetes ProHealth Home Page.
Postings on innovative pharmacy based disease management from the Pharmacy Care Systems web site at Auburn University School of Pharmacy.
A disease management corporation based in Miami Florida. Uses Registered Nurses on their 24 hour line.
The focus is on cancer care and uniform standards of clinical practice.
This center for Immunology and respiratory medicine is actively developing program related to asthma, Chronic obstructive pulmonary disease (COPD) and tuberculosis (TB). The have a Managed Care Consult Line with an 800 number geared toward use by case managers and medical directors. Note their programs using nurses on the phone.
Short brief on how NE Medical Center deloying home health and disease management applications (4/96)
A systems consulting and integration company focused on healthcare. Their Managed Care focus includes disease state management, but does not elaborate on how it is implemented.
This Bio-Tech Pharmeceuticals Company has pharmeceutical disease management programs, with teams focused on hemophilia, growth disorders, cystic fibrosis, Gaucher's disease, endometriosis/precocious puberty, and multiple sclerosis.
Home Health Q&A section includes definition of disease state management and their program.
A part of a more comprehensive package of health services called Optum, from United HealthCare Corporation, NurseLine uses specially trained nurses.
Info on disease prevention and management programs called "Performance Health" at the PCS Health Systems Home Page.
Has an outcome monitoring program and disease outcome evaluations for gastrointestinal and Dyslipidemia.
Offers strategic management and transaction services related to disease management.
Conducting market research via the web on disease management and outcomes. No data provided, only input requested.
This managed care company has a Childhood Asthma and Congestive Heart Failure Management program, in addition to some interesting health management programs.
Announcement of a vision care disease management support service with CIBA Vision Ophthalmics, at Express Scripts.
Conferences
Books/Journals
Publishes peer review articles on all aspects of disease management. No articles here, just information on the journal.
A journal from ADIS for practical knowledge on DM. This site allows you to request a sample copy. Pharmacologic focus.
Book on trends and developments in drug outcomes research.
A Pharmacologic Approach to Heart Disease Management by Joel Kupersmith MD and Prakash Deedwania MD, from a health science book store site.
Other Resources on Disease
Part of Victoria Canada's Cancer and Heart Offensive, this site reviews current activity in the context of the health goals and targets for cancer and cardiovascular disease set nationally and current health status indicators for Victoria, and provides information about the role of various organisations and
programs. Information on disease management of cancer and heart disease.
An international network of individuals and institutions committed to preparing, maintaining, and disseminating systematic reviews of the effects of health care. This site is not to be missed.
Information on the management of dementia from the Alzeheimer's Disease Society.
Information on the HSQ-12 and health assessment instruments with great links from Duke University Informatics site. Dont' miss their HealthCare Coding Systems page while you're there.
National Library of Medicine's web site to assist you in locating data collection information related to disease management and expert consensus statements.
A site that indexes clinical/medical resources on the Internet by disease type
A non-profit public service organization. The TRUST is dedicated to improving health and health care by distributing standardized, high quality instruments that measure health and the outcomes of medical care.
can be reached by e-mail at webster@katsden.com
