One of the reasons that Americans live longer than in earlier times is said to be the significant improvements in the diagnosis and treatment of disease. However, the effectiveness of treatment is limited when patients do not follow the medi¬cation regimens they are prescribed. As many as 20 percent of patients in treat¬ment for hypertension are considered noncompliant, meaning they do not take their medication as prescribed. This is caused by a number of factors, including a lack of insurance, the cost of medications, and poor patient education.
An example of the costs addressed here is best exemplified by diabetes. This is a potentially life-threatening illness. When diabetes is not managed, patients can suffer blindness, loss of limbs, and other costly conditions such as heart disease. The operant term is costly. Disease management programs have demonstrated that long-term and acute costs can be reduced. This cheers insurance companies, patients and their families, and folks looking for a career helping people.
Disease management can be defined as proactive management of a chronic medical condition that brings together physicians and support services to assist patients in taking better care of themselves. Disease management programs are most common in the care of persons with diabetes, allergies and asthma, heart disease, and more recently, depression and prenatal care.
Your participation in the disease management industry could take one of several directions:
- Direct patient care as an independent operator
- Patient care as an agent of an insurance company
- Direct patient care as an employee of an assisted living operator, and more.
Working in this field usually requires specialization in one disease and its management. It means keeping up with the latest successes in management and treatment in professional journals as well as popular sources.
The latter is important because this is where patients often get their information. It means having extensive knowledge of local resources for information, supplies, treatment, etc.
Disease management program staff, whether independent or not, are people who can communicate up and down the care chain. Physicians, nurses, home health aides, family members, and neighbors may all be recruited to support a chronically ill client. Your job is to keep them on task and communicating with each other, you, and the patient as necessary.
Disease management programs can be limited to calling the patient on a reg¬ular or even scheduled basis to discuss medication compliance, diet, and general health. It may mean making sure diabetes supplies are ordered and delivered or prescriptions reordered and refilled. Disease management will mean educating patients and caretakers about medications, disease complications, limitations, and more.
Education may simply take the form of providing literature. More elaborate programs may include group meetings or face-to-face teaching.
Some disease management staff never meet their patients; the relationship is strictly via phone or across the Internet. There are high-tech programs that provide monitoring and reporting equipment for essential data. In diabetes management a patient’s glucose level may be sent from the testing device directly to your computer with alarm systems to alert you when additional action or sup¬port is necessary. Blood pressures and other circulatory statistics can be similarly monitored and reported to the disease management professional or program.
While you need extensive knowledge of the disease in which you are specializ¬ing, you will also need to demonstrate genuine care for each of your patients and be able to be assertive with the patient and the individuals in their support network.
Learn more from the Disease Management Association of America (DMAA) http://www.onemedplace.com/network/list/cid/1892.
The National Committee for Quality Assurance offers accreditation programs http://www.ncqa.org/tabid/152/Default.aspx.
For information about specific problems, check with the Allergy and Asthma Disease Management Center www.aaaai.org/aadmc – American Diabetes Association www.diabetes.org American Benefits Council www.americanbenefitscouncil.org American Heart Association www.americanheart.org Asthma & Allergy Foundation of America www.aafa.org The Global Initiative for Chronic Obstructive Lung Disease http://goldcopd.com
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