Patient centric Disease Management
The most prominent model of disease management today is the payor-driven disease management which aims to reduce costs of high risk patients. Other models are pharma-sponsored disease management which promotes usage of drugs from that pharma or employer-sponsored wellness program targeting improvement in productivity and higher employee satisfaction. None of these models have primary objective of making a significant difference in the quality of life of chronic patients through disease management services.
The success of payor-driven disease management programs is mostly measured with cost indicators and outcomes. The strategy for managing a chronic disease revolves around defining clinical protocols, patient education and continuous monitoring. This model of disease management is focused on short-term management of high-risk patients rather than long-term enablement of patients to lead a better quality of life. Consequently, these programs have limited success.
Patient-centric disease management programs need to be modeled as a service designed for patient. The singular most important objective of this program would be to make a positive difference in quality of life of chronic care patients and their family. The parameters for measuring success of the disease management program will be driven by this objective. Organizations like payors, providers, employers and pharmas who have an interest in managing disease of the patient can sponsor or contribute in subsidizing the service costs for patients.
Like any disease management program, patient-centric disease management requires an active participation from physicians. Patient-centric disease management services can be offered by:
1. Provider organizations
2. A disease management organization having a network of physicians to support this program. Physicians get incentives for their participation.
3. A disease management organization, aligned with payors who will influence physician participation in program.
This program will involve complete commitment from patient themselves and their families as well. Motivational programs designed to increase adherence to the program will be an essential component of the program. Skilled care managers with emotional sensitivity are critical for the success of program. Personalized care will be core to the patient-centric disease management. Apart from services providing ready access to care, to improve the quality of life of chronic patients, a plethora of support services designed to make tasks of daily living convenient need to be incorporated into the disease management program. There should be a lot of emphasis on community forums and networking events between patients with similar backgrounds where they can share experiences, support and encourage each other. This program needs to extend much beyond improved care coordination and outcomes. Ultimately, it needs to create an experience for patients and their families where they feel much comfortable and confident in coping with the disease.
The key challenge involved in patient-centric disease management business model would be the ability to demonstrate value in terms of improved quality of life and better clinical outcomes. Most of the benefits accrued to patients will be intangible benefits which are hard to quantify. A discernible improvement in disease state definitely cannot be assured for all the chronic patients. Under the circumstances, convincing patients to enroll for a program and then continue with the program requires much innovation in designing programs. Another critical success factor is making it lucrative for physicians to invest time for contributing to this program. If all the necessary ingredients for a patient-centric disease management program are brought together, this program will certainly see unprecedented success as it will make an impact where it matters most: it will help patients and their families lead a better life!
