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Standard Outcome Metrics and Evaluation Methodology for Disease Management Programs

机译：疾病管理计划的标准结果指标和评估方法

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Disease management is conceptually recognized as being a significant approach for closing the gaps in care identified by the Institute of Medicine as contributing to poor outcomes from our health care system. That conceptual credibility has been bolstered by the disease management industry through the adoption of an industry-standard definition of disease management and through the development and implementation of disease management accreditation programs by the National Committee for Quality Assurance, Utilization Review Accreditation Commission, and Joint Commission on Accreditation of Healthcare Organizations. The clinical and financial outcomes of disease management programs continue to be suspect, however, due to the lack of an industry standard set of outcomes metrics and a uniform methodology for evaluating those metrics. As a result, the ability to evaluate the effectiveness of any individual program is compromised, and the ability to effectively compare results across programs of different delivery designs is non-existent. To address this issue, American Healthways and Johns Hopkins convened a consensus conference of nearly 150 health care professionals representing health plans, hospitals, practicing physicians (both primary care and specialty), and other health care professionals. The conference purpose was to develop a "first-step" set of metrics and a uniform methodology that could be applied industry-wide to enable meaningful comparisons between programs and to allow evaluation of individual programs whether "homegrown" or "outsourced." The consensus conferees recognized that there were many paths to this objective, but that they had to land on a set of metrics and a methodology that was "doable" in light of today's technology and data availability. The results of their consensus effort follow.
机译：从概念上讲，疾病管理被认为是缩小医学研究所发现的造成我们医疗体系不良结果的空白。通过采用疾病管理的行业标准定义，以及国家质量保证委员会，使用审核委员会和联合委员会制定和实施疾病管理认证计划，疾病管理行业增强了这种概念上的信誉。卫生保健组织认证。但是，由于缺乏行业标准的结果指标集和评估这些指标的统一方法，疾病管理计划的临床和财务结果仍然令人怀疑。结果，评估任何单个程序的有效性的能力受到损害，并且不存在跨不同交付设计的程序有效比较结果的能力。为了解决这个问题，美国健康之道和约翰·霍普金斯大学召开了共识会议，由代表健康计划，医院，执业医师（初级保健和专科医师）以及其他卫生保健专业人员的近150名卫生保健专业人员组成。会议的目的是开发一套“第一步”的度量标准和统一的方法，这些方法可以在整个行业范围内应用，以实现程序之间的有意义的比较，并允许对单个程序的评估，无论是“本土”还是“外包”。协商一致的参加者认识到实现这一目标的途径很多，但是他们必须依靠一套衡量标准和一种方法，鉴于当今的技术和数据可用性，这种方法是“可行的”。他们一致努力的结果如下。

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