title: Organizational technologies of chronic disease management programs in large rural multispecialty group practice systems.
abstract: Four large rural multispecialty group practice systems employ a mix of organizational technologies to provide chronic disease management with measurable impacts on their patient populations and costs. Four technologies-administrative, clinical, information, and social-are proposed as key dimensions for examining disease management programs. The benefits of disease management are recognized by these systems despite marked variability in the organization of the programs. Committees spanning health plans and clinics in the 4 systems and electronic medical records and/or other disease management information systems are important coordinating mechanisms. Increased reliance on nurses for patient education and care coordination in all 4 systems reflects significant extension of clinical and social technologies in the management of patient care. The promise of disease management as offered by these systems and other auspices are considered.
authors.affiliation: Department of Health Policy and Management, School of Rural Public Health, Health Science Center, Texas A&M University System, College Station, USA. gamm@srph.tamhsc.edu
authors.forename: Larry
authors.initials: L
authors.lastname: Gamm
authors.forename: Jane Nelson
authors.initials: JN
authors.lastname: Bolin
authors.forename: Bita A
authors.initials: BA
authors.lastname: Kash
mesh_terms: D002908:Chronic Disease; D019468:Disease Management; D006123:Group Practice / Q000458:organization & administration*; D006801:Humans; D008511:Medicine; D019035:Rural Health Services / Q000458:organization & administration*; D013038:Specialization; D013672:Technology; D014481:United States