title: The introduction of ambulatory electrocardiographic monitoring for the diagnosis and management of myocardial ischemia.
abstract: We report on the introduction of a new technology and a new method for the management of chronic coronary artery disease into a managed care environment. The introduction incurred substantial resistance from subspecialty consultants, primary care physicians, and top management. Strategies were developed to overcome these resistances. Modification of the program as well as the development of incentives occurred. These measures continue to evolve. The program, to date, has achieved approximately 50% penetration. The demonstration of better health outcomes and financial savings will almost certainly temper the resistance encountered from all three groups identified.
authors.affiliation: Heritage Medical Systems, Bakersfield, CA, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Corder
authors.forename: J L
authors.initials: JL
authors.lastname: Monaco
authors.forename: T
authors.initials: T
authors.lastname: Kraf
authors.forename: R I
authors.initials: RI
authors.lastname: Levin
mesh_terms: D001291:Attitude of Health Personnel; D002140:California; D017046:Cost Savings; D004059:Diffusion of Innovation; D019468:Disease Management; D015716:Electrocardiography, Ambulatory / Q000706:statistics & numerical data*; D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration*; D017146:Models, Organizational; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D018581:Technology Transfer