our disease management program to be successful, we must begin with
knowledgeable providers. To ensure providers have an adequate knowledge
base, we should begin with academic detailing. "Academic detailing"
occurs when the provider learns about the best practices for the disease
of interest from a recognized expert in the field. This can and should
be done through a variety of settings --- general staff and departmental
meetings, grand rounds, video conferences, etc.
the didactic sessions, information should be available to the providers
at the points of care in either a low-tech (laminated practice guidelines)
or high-tech (computerized interactive programs) format. This would
assure that the clinical decision support information would be conveniently
available for the providers.
also have to support the physician's work. The disease management
structure must not be seen as another layer of paperwork that does
not support or facilitate the physician's job. The support initially
required is to identify for the physician those patients who meet
the eligibility for the disease management program and get them enrolled.
The physician should also get information about the essential elements
of the patient’s participation in disease management. The physician
should get reminder alerts when a needed patient activity has not
occurred. Providers should be alerted whenever the defined values
for a patient's treatment plan do not meet the appropriate standard
requires feedback about individual patients on a regular basis as
well as summary measures of how is particular population of patients
is doing relative to the best practice guidelines, and how a particular
provider is performing compared to his peers and the evidence-based