Thursday, September 16, 2010

Disease Management: A Rose By Any Other Name

In its moments of fancy, the Disease Management Care Blog likes to imagine that it's one of the uncommonly reasonable voices in the healthcare wilderness. Because it links a lot of the peer-reviewed scientific literature, it fancies itself as an island of insight in a sea of evidence-poor rhetoric. Maybe it's better thought of as a narcissistic wannabe that needs to rethink its dreams of vast blogging revenue. Whether the thousands of regular DMCB readers plus one spouse agree with any of those assessments remains an open question, but one thing is clear: the DMCB is one of the remaining intellectual redoubts that's still loyal to the term "disease management."

It wasn't too long ago that acclaim was awarded to to anyone with those two words on their lips. The term's appearance on marketing materials guaranteed fat contracts. Including "disease management" in the title of a manuscript or as a proposed MeSH term was scientific journal editor catnip. That and its inflated jargon (engagement! outcomes!) was enough to prompt a HHS Secretary to turbocharge an industry. Health insurer execs coveted disease management more than their ability to deny life-saving transplantations in children. Budgets doubled, titles inflated and careers were launched.

We all know what happened next. The downward spiral of incredulity reached critical mass when the debacle called Medicare Health Support transpired. When the depths of physician hostility became apparent, it was almost a near death experience. Recriminations led to corporate retreats, which then revamped business models and refreshed branding. Among the many outcomes was that the moniker "disease management," like Britney Spears, partially hydrogenated fats and Teletubbies, lost its luster. Even the "Disease Management Association of America" dropped its name in favor of "DMAA, The Care Continuum Alliance."

But seriously, change happens and, to paraphrase a famous bard, a rose by any other name still smells as sweet. While newer versions of remote coaching services for chronic illness are still going strong, end-to-end and interlocking care programmatic interventions in wellness, prevention, workplace health promotion, behavioral health, technology-enabled care, pharmacy and complex care management are providing a potent mix of patient services to the vast majority of self and fully insurance programs plus the Medicaid insurers. If its big and it's tackling quality and cost in cohorts, networks, populations or books of business, it makes little difference what you actually call it.

It should be no surprise, then, that the DMAA has just changed its name again, erasing all traces of those two words. The newly stamped Care Continuum Alliance represents a huge multi-dimensional industry with a critically important role to play as health care continues to evolve. You can read all about it here.

Call it a foolish loyalist, but the steadfast DMCB is sticking to its guns. Do a Google search on the phrase "disease management" and you'll find that the number of web pages appearing with that term in the last year number over 1.2 million. Perform a search for peer-reviewed published literature using the term "disease management" in the last five years, and you'll find there are more than 7000 articles. Finally, there are over 500,000 blogs that have used the phrase.

In fact, the DMCB predicts the term "disease management" will make a comeback. And its not because of Healthway's hot-off-the-presses release about its achievements in that watershed Medicare Health Support pilot mentioned above.

In a future post, the DMCB will explore why it thinks the phrase "disease management" may still have legs.

In the meantime the DMCB is proud to announce that it's come up with it's own logo. Good bye flamingo eyes.


Michelle W said...

Ah, the flamingo eyes are gone? How sad. For the record, I thought they were rather fetching myself. And just to let you know, I think you are one of the saner voices in the blogosphere; certainly, while I don't know much about Disease Management, I enjoy reading what you have to say on it and other subjects.

GlassHospital said...

Is the caduceus impaling the computer or emerging regally from it to stamp out disease?

In spite of my query, I like it. I hope you paid a consultant oodles for it.


Jaan Sidorov said...

The logo was provided by a commercial graphics design company at a very competitive rate, all handled over the internet. Next stop: a DMCB logo with or without polo shirts, with one for the spouse.