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Full-Text Articles in Medicine and Health Sciences

A Decentralized, Patient-Centered Approach To Diabetes Disease Management In The Primary Care Setting, Michael Toscani, John P. O'Connor, David B. Nash Dec 2001

A Decentralized, Patient-Centered Approach To Diabetes Disease Management In The Primary Care Setting, Michael Toscani, John P. O'Connor, David B. Nash

College of Population Health Faculty Papers

Although many disease management programs have been developed for diabetes, no single design has proved best for all providers and patient populations. Cost effectiveness is especially relevant to diabetes programs because significant costs of the disease may come from complications that occur later in life, while the costs of the program are incurred immediately. For this reason, diabetes disease management programs with positive outcomes and low implementation costs are of particular importance. We report here on the outcomes of a pilot test of the Steps to Health program developed by Abbott Laboratories. The Steps to Health program was designed to …


From Product Dispensing To Patient Care: The Role Of The Pharmacist In Providing Pharmaceutical Care As Part Of An Integrated Disease Management Approach, Laura T. Pizzi, Jean M. Menz, Geneen R. Graber, Dong-Churl Suh Dec 2001

From Product Dispensing To Patient Care: The Role Of The Pharmacist In Providing Pharmaceutical Care As Part Of An Integrated Disease Management Approach, Laura T. Pizzi, Jean M. Menz, Geneen R. Graber, Dong-Churl Suh

College of Population Health Faculty Papers

During the past decade, the profession of pharmacy has changed dramatically. The Doctor of Pharmacy degree has replaced the Bachelor of Science degree as the first professional degree offered at most accredited U.S. pharmacy schools. Advanced clinical training is now a mainstay of pharmacy training, and this has enabled pharmacists to contribute to disease management efforts. In addition, technological improvements in prescription processing have afforded pharmacists more time to participate in disease management activities. This paper describes how the role of the pharmacist has changed and reviews the results of programs involving pharmacists as disease management providers in the areas …


The Importance Of Individualized Pharmaceutical Therapy In The Treatment Of Diabetes Mellitus, David B. Nash, Jennifer B. Koenig, Karen D. Novielli, Renee Liberoni, Miriam Reisman Nov 2001

The Importance Of Individualized Pharmaceutical Therapy In The Treatment Of Diabetes Mellitus, David B. Nash, Jennifer B. Koenig, Karen D. Novielli, Renee Liberoni, Miriam Reisman

College of Population Health Faculty Papers

Individualized pharmaceutical care for patients with diabetes is necessary for several reasons. First, diabetes is a highly complex disease caused by the interplay among genetic, physiological, and environmental factors that vary from individual to individual. Second, the profile of patients with diabetes has evolved to include people of all ages and socioeconomic backgrounds, with varying medical histories and health behaviors. Third, diabetes often occurs concurrently with other medical conditions, especially in certain groups, such as the elderly. While the treatment goals for all patients with diabetes are the sameto stabilize and maintain healthy blood glucose levels to prevent serious complicationsthe …


Pain Control In Healthcare Organizations: Developing Effective Disease Management Programs, C. Richard Chapman, Stephen D. Lande, Bill H. Mccarberg, David B. Nash Sep 2001

Pain Control In Healthcare Organizations: Developing Effective Disease Management Programs, C. Richard Chapman, Stephen D. Lande, Bill H. Mccarberg, David B. Nash

College of Population Health Faculty Papers

Although medicine possesses the knowledge and technology for preventing or relieving most pain, poor pain control is still widespread. Unrelieved pain causes unnecessary suffering and increases health care expenditures. Among the barriers to improving pain control are poor provider education in pain management, misguided beliefs about the inevitability of pain and the dangers of pain medication, provider resistance to changing practice patterns, and administrative resistance to implementing improvements that incur short-term costs but lead to long-term savings. In short, poor pain relief in America's health care institutions is a system issue, and improvement requires a system-wide change. An effective program …


The Field Of Disease Management At The Crossroads: An Interview With David B. Nash, Md, Mba, T. J. Basting Jun 2001

The Field Of Disease Management At The Crossroads: An Interview With David B. Nash, Md, Mba, T. J. Basting

College of Population Health Faculty Papers

As David B. Nash, MD, MBA, takes the helm of Disease Management as Editor-in-Chief, the practice of disease management—now a decade old—depends on its practitioners to continue to provide "economic proof of concept." This effort to accrue the credibility needed to design and fund programs will provide further evidence that new technologies can be integrated into care programs across large populations to reduce costs while improving healthcare and access to it.


Quality Improvement Tools In Disease Management, Lisa E. Paddock, Amy L. Phillips, Peter Chodoff Jun 2001

Quality Improvement Tools In Disease Management, Lisa E. Paddock, Amy L. Phillips, Peter Chodoff

College of Population Health Faculty Papers

Disease management programs require constant monitoring to assure quality and address problems efficiently. To initiate continuous quality improvement in a disease management program, there are several methods available to identify potential problems within the program that may be affecting quality. Some common quality improvement instruments include the Plan-Do-Check-Act model, check sheets, and so forth. Whatever model is used, Statistical Process Control using flow charts, histograms, Pareto diagrams, scatter diagrams, control charts, and cause-and-effect diagrams provides a better understanding about how the organization's processes are functioning. These tools facilitate problem recognition and allow an organization to meet established standards of quality …


Chief Medical Officers' Perceptions Of Disease Management Programs, Gang Xu, Lisa E. Paddock, John P. O'Connor, David B. Nash, Mark Zitter Mar 2001

Chief Medical Officers' Perceptions Of Disease Management Programs, Gang Xu, Lisa E. Paddock, John P. O'Connor, David B. Nash, Mark Zitter

College of Population Health Faculty Papers

The purpose of this article is to examine chief medical officers' (CMOs) perception of disease management programs. Five open-ended questions, each addressing a major issue in the development of disease management programs, were given to 31 CMOs who attended a series of invitation-only conferences on disease management in the fall of 1999. Qualitative data analysis was conducted using the transcripts on each of the issues. Overall, the CMOs viewed the emergence of capitated disease management programs positively. They considered the population of a program to be the contractual patients and/or those at risk for the target disease. On the issue …


Measurement Of The Impact Of Winona Health Online, David B. Nash, David Shulkin, Florence Comite, Ron Loeppke, Bruce Van Cleave, Robert Kane, Jon Christianson, Douglas Pousma Mar 2001

Measurement Of The Impact Of Winona Health Online, David B. Nash, David Shulkin, Florence Comite, Ron Loeppke, Bruce Van Cleave, Robert Kane, Jon Christianson, Douglas Pousma

College of Population Health Faculty Papers

The purpose of this article is to present the methodology to study the clinical and financial outcomes associated with the use of Winona Health Online, a novel community-wide interactive healthcare Website in Winona, Minnesota. Outcome methodology was developed by the University of Minnesota School of Public Health and the Carlson School of Management in cooperation with nationally recognized outcomes and disease state management experts, healthcare practitioners in Winona, statisticians, and health economists. The main areas of measurement include health status, satisfaction, cost and utilization of services, and clinical quality.