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Disease Management

Disease Management. Providence Health System Joseph Siemienczuk, M.D. March 2006. Program Description. How patients are identified? What is considered participation? Role of physician?. DMAA definition of disease management. (1) Population identification processes

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Disease Management

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  1. Disease Management Providence Health System Joseph Siemienczuk, M.D. March 2006

  2. Program Description • How patients are identified? • What is considered participation? • Role of physician?

  3. DMAA definition of disease management (1) Population identification processes (2) Evidence-based practice guidelines (3) Collaborative practice models including physicians and support staff (4) Patient self-management education (5) Process and outcomes measurement, evaluation and management (6) Routine reporting and feedback

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  14. Full Implementation Project Goal: A 20%  in all of these key outcome and process measures N=8,965

  15. Full Implementation N=9,301

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  17. Patient Identification • Clinical Problem Lists (CareManager) • Clinical Indicators (CareManager) • Risk Stratification (CareManager) • Health Risk Assessment • Claims Data-Medical/Pharmacy • Concurrent Review

  18. Participation • All patients identified with a chronic condition are considered participating through their relationship with their medical home

  19. Physician Role • Managing CareManager Patient Lists • Point of Care: Evidence-based care prompted by dashboard • Quality Incentive Program • Annual Professional Review

  20. Joseph Siemienczuk, MDChief Medical OfficerProvidence Medical Group3601 SW Murray Blvd. Suite 45Beaverton, OR 97005503-574-9810joseph.siemienczuk@providence.org

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