Disease Management (DM) organizations are facing incredible challenges from outside and inside the industry. A focus on costs can help both managed care organizations and self-insured employers to be more open to the potential of DM in the US. The steep increase in spending for covered medical services has been the most disturbing development over the past 2 years. This trend is largely reflected by the average premium growth. Provider revenues per privately insured person (a proxy for spending on services) increased 6.6% in 1999, compared with 5.1% in 1998, and 3.3% in 1997. At the same time, consumer demand for quality service, easy access, and reasonable deductibles and co-payments has risen nationally. There is demand for greater accountability from the medical and administrative areas. Common challenges for DM entities mandate demonstrated quality, cost of care, outcomes and access to capital markets. Public debate over healthcare models and services has increased consumer awareness of issues that were previously internal matters. Government leaders are responding to consumer pressure with an increasing focus on healthcare issues, as evidenced by the Health Insurance Portability and Accountability Act enacted in 1996 by the US. The end result of all these changes has been an extremely competitive marketplace which requires increasingly sophisticated methods for sharing and tracking of information on patients, members, services, costs and quality. Today, DM executives increasingly view information technology as an essential tool for addressing these challenges and ensuring the survival of the DM industry. Disease managers have always understood the need for sophisticated systems to collect and track disease specific data, but the cost was a hindrance. As DM organizations evolve, there is a critical need for new technologies capable of cost effectively linking all the various providers, and ultimately the patient. Recent technological advancements include the Intranet, an Internet-related technology that has the potential to dramatically improve a DM organization's ability to meet the needs of the marketplace. This technology and its implications for DM are discussed in this article.
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