The Health Care Professional's Guide to Disease Management: Patient-Centered Care for the 21st Century

by Couch, James

• ISBN13: 9780834211667
• ISBN10: 0834211661
• Format: Paperback
• Copyright: 1996-01-14
• Publisher: Jones & Bartlett Learning

Summary

The Health Care Professional's Guide to Disease Management is an essential reference for physicians, nurses, pharmacists, allied health professionals, and public health practitioners working in the area of disease management. In today's health care market where pressure is on both providers and managed care organizations to deliver high quality care to defined populations efficiently, knowledge of disease management is crucial. The book includes discussions of evidence-based medicine, clinical practice guidelines, and outcomes management.

Table of Contents

Contributors	ix	(2)
Foreword	xi	(4)
Philip Caper
Preface	xv	(2)
Acknowledgments	xvii
Chapter 1--Disease Management: An Overview	1	(28)
James B. Couch
Origins and Evolution	1	(2)
Definition	3	(1)
Health Care Value	4	(2)
What DM Is Not (or Should Not Be)	6	(1)
Why DM Is So Important Now	7	(1)
The DM Process	8	(9)
Stakeholder Needs from Disease Management	17	(2)
Role of DM in the Broader Health Care Industry: Health Care Value Purchasing	19	(1)
Total Health Management	20	(2)
Alliance Management To Complete the Puzzle	22	(1)
A Case Study in Alliance Management	23	(1)
A Possible Future Course for Disease Management	24	(2)
Summary and Prospectus	26	(3)
Chapter 2--Disease Management: A Public Health Perspective	29	(24)
Paul K. Halverson
Glen P. Mays
Disease Management Concepts and Methods	29	(2)
Public Health Practice and Its Relevance to Disease Management	31	(9)
Similarities and Differences Between Disease Management and Public Health Practice	40	(6)
Remaining Issues and Next Steps	46	(4)
Conclusion	50	(3)
Chapter 3--Evidence-Based Medicine	53	(28)
Tony Felton
Defining EBM	53	(1)
Background of EBM	54	(1)
From Theory to Practice?	55	(6)
Physicians and EBM	61	(4)
How Will EBM Affect Key Constituents within Health Care?	65	(8)
The Role of Information Technology	73	(2)
Creating an Environment To Encourage EBM	75	(1)
New Ways of Working as a Consequence of EBM	76	(1)
Looking to the Future	77	(4)
Chapter 4--Outcome-Validated Clinical Practice Guidelines: A Scientific Foundation for Disease Management	81	(26)
Scott Weingarten
Geneen Graber
Treatment and Diagnostic Overutiliztion: A Health Care Dilemma	82	(1)
Past Attempts at Medical Cost Containment	82	(3)
The Concept of Disease Management	85	(1)
Physicians' Perspective on Disease Management	85	(1)
Clinical Practice Guidelines	86	(10)
Outcome Measurement	96	(4)
Recent Disease Management Programs Using an Evidence-Based Approach to Guidelines	100	(7)
Chapter 5--The Role of Outcomes Management in Disease Management	107	(30)
Spencer Borden IV
Collection and Evaluation of Health Care Data	109	(12)
Analysis of Health Care Data	121	(5)
Production of Measures	126	(9)
Conclusion	135	(2)
Chapter 6--Information System for Disease Management	137	(34)
David J. Brailer
Jason Dandridge
Disease Management Information Strategy	139	(10)
Core Technologies	149	(14)
Development and Implementation	163	(5)
Discussion and Conclusions	168	(3)
Chapter 7--Disease Management: Making It Work--A Study in Implementation Strategies and Results in an Integrated Delivery System	171	(20)
John J. Byrnes
John Lucas
Margaret J. Gunter
Lovelace Health Systems	172	(1)
EPISODES OF CARE (TM)	172	(17)
Summary and Additional Lessons Learned	189	(2)
Chapter 8--Disease State Management in Managed Care Organizations	191	(32)
Robert E. McCormack
HEDIS	199	(1)
History of DM in MCOs	199	(1)
Current DM Programs in MCOs	200	(23)
Chapter 9--Disease Management in Pharmaceutical Companies	223	(32)
Harald Rinde
Changes in the Health Care Market	223	(3)
Changing Customers and Changing Needs in the Health Care Market	226	(7)
The Role of Disease Management	233	(1)
Development of the Disease Management Concept	234	(1)
Does Disease Management Produce Results?	235	(1)
Pharmaceutical Companies and Disease Management	236	(5)
Key Factors for Pharmaceutical Companies' Success in Disease Management	241	(3)
Benefits to Pharmaceutical Companies from Disease Management	244	(5)
Pharmaceutical Companies' Approach to Disease Management	249	(2)
Future of Disease Management in the Pharmaceutical Industry	251	(4)
Chapter 10--Disease Management Purchasers' Perspectives	255	(34)
Larry L. Hipp
Purchasers Perspectives	256	(3)
Occupational and Environmental Medicine Perspective	259	(2)
Health Promotion and Demand Management	261	(3)
The Purchasing Community	264	(5)
The Accreditation and Measurement Community	269	(4)
Examples of Disease Management Programs in the Purchasing Community	273	(8)
Future Challenges and Opportunities	281	(8)
Chapter 11--Total Health Management: The Nursing Perspective	289	(10)
Carol Geary
Total Health Management--Philosophy and Operation	289	(7)
Conclusion	296	(3)
Chapter 12--Disease Management as Patient-Centered Care	299	(26)
David Levy
History of Health Care Management	300	(6)
Insufficiencies of the Old View	306	(4)
Patient-Centered Care as the New Paradigm of Health Care Management	310	(5)
Putting It All Together	315	(7)
Conclusion	322	(3)
Epilogue	325	(6)
Senator Bill Frist
Index	331	(14)
About the Editor	345