Monitoring and evaluating disease management: information requirements

This paper addresses information essential to the creation, monitoring, and evaluation of disease management programs within managed-care organizations. Sound procedures for the collection and analysis of data are vital components of any effective disease management program. This presentation argues for a systemwide, rather than an atomistic, approach to data collection and analysis. Because every health system serves different populations, reliable demographic and health resource use data must be collected. Similarly, baseline data on physician prescribing behavior, patient compliance, and treatment costs are necessary to identify areas in need of improvement. Particular care must be taken to ensure that valid statistical models are developed to reflect the realities of the health system. The strengths and weaknesses of various internal and external data sources are discussed, with an emphasis on correlating and integrating information to provide comprehensive analyses of treatments and outcomes. The effects of different financial arrangements on data issues are also discussed, particularly in terms of contracting issues at successive stages in the development of a disease management program. This paper examines, in detail, data issues relating to monitoring prescribing behavior, modeling therapy interventions, classifying outcomes, and utilization of resources and treatments. Finally, this presentation makes specific recommendations for designing valid procedures for data collection and analysis.