The Role of Evidence-Based Medicine in Disease Management

Author: Keckley P.H.

Source: Disease Management & Health Outcomes, Volume 11, Number 7, 2003 , pp. 429-437(9)

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Abstract:

Evidence-based medicine (EBM) is the conscientious application of scientific best practice by clinicians in concert with the patient’s understanding and values. Recent studies by the Institute of Medicine (Washington, DC, USA) and others have noted the gap that exists between scientifically supported approaches to care and day to day practice by clinicians. Compounding this problem of non-adherence by providers, researchers have noted that patient compliance also falls short. As a result, avoidable costs from inappropriate variability in practice patterns coupled with patient noncompliance are a significant focus of payor attention.

Disease management programs, currently focused on chronic conditions, provide the most logical launch for these efforts. However, disease management programs must expand their focus to target non-adherence by providers in addition to noncompliance by patients. To this end, changes are necessary in the disease management model to enable physicians to be more actively engaged as coaches for acute and chronic patient populations and expand the use of information technology to increase participation in and the cost-effectiveness of these programs.

Payors will migrate to this expanded model, thus providing expanded market opportunity for care management programs. Adherence to evidence-based guidelines by providers and patients will be the focus of these companies, with significant opportunity for reduced costs, reduced inappropriate variability and improved outcomes.

Document Type: Review article

Affiliations: 1: Vanderbilt Center for Better Health, Nashville, Tennessee, USA

Publication date: 2003-01-01