Be committed, patient with new DM programs
Results don’t come overnight
Whether you develop your own disease management program or buy one from a vendor, be prepared to wait for the results, say representatives of two organizations with locally run disease management programs.
A disease management program can be cost-effective and rewarding on a human level, says Jay Want, MD, medical director for Denver-based Physician Health Partners. Want says organizations developing and running disease management programs should be committed to doing the right thing as well as saving money.
"There are going to be times when you question whether the program is beneficial, especially when you don’t yet have data to analyze. An organization should commit to disease management because they feel it’s the right thing and the moral thing to do," Want says.
Whether you buy one or create your own, keep in mind that a disease management program requires a substantial commitment in terms of money and staff.
"You can’t do it half-heartedly and hope to have success. You have to be dedicated to making the investment," says Jay Salvio, BS, MSN, director of the Health Management department at ConnectiCare, a Farmington, CT-based independent practices association (IPA) HMO.
Here are some other things to remember if you’re considering disease management:
• Take a long-term view. The minimum period for calculating your investment should be two to three years. "If your expectation is to show a return in the next quarter, disease management is not a program for you," Want says.
It takes a long time to see a return on your investment for some conditions like diabetes, Salvio says. For congestive heart failure and asthma, you can tell the investment has paid off in a shorter time, he adds.
• Track your data in a disciplined way. Understand how much you’ve spent and how much return you’ve gotten. You may be in the red for a while, but make sure you’re headed in the right direction.
• Make sure you have software to support your program. "It seems like we turned the corner once we got the software. IT [information technology] helped us formalize and standardize what we do," says Rosalind Bader, director of case management for Physician Health Partners.
• Make sure your staff are knowledgeable and committed. One of the reasons for the success of ConnectiCare’s disease management program is low staff turnover, Salvio says. "All the nurses who were present when the programs were developed are still here. This is extremely important because of the personal relationship they have developed with the members and the continuity of care," he adds.
• Be prepared to do a lot of continuous quality improvement. Disease management is an evolving process. Analyze your data and see where you need to make changes.
• Make sure you have buy-in from everyone in your organization before you begin. "You need support from the chief executive officer and board of directors down to the people who run the program on a daily basis," Salvio says.
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