'Health and disease management' is a clinical improvement process aimed at ensuring that the best practices known to medical science are incorporated with minimal variation over the entire continuum of carl. The University of Pennsylvania Health System (UPHS) is an academic, integrated healthcare delivery system committed to implementing this approach to care by all providers and at all sites. This report outlines our approach to design, implementation, outcomes tracking and improvement, and highlights how the educational, service and research missions of the academic health system add value to the comprehensive health and disease management approach. Education, a key component of health and disease management implementation, is an area. of particular strength in academic systems. Provider education, in particular, can be effectively achieved by academic detailing, led by specialists and utilising the involvement of skilled educators. A key requirement for programmes such as these is the need to frequently update the best-practice clinical guidelines. The academic health system is ideally poised to rapidly incorporate clinical advance and emerging knowledge into disease management programmes that can reach a wide audience. Health and disease management offers a unique research opportunity fur academic physicians who can adapt the use of prc,cess control measurement techniques, which have long been the major approach to performance measurement in industry, to the healthcare environment. Clinical evaluation and outcomes management, has the potential to become widely embraced as a legitimate and important form of research. Substantial effort and resources must be dedicated to gain provider buy-in and achieve compliance. We believe that academic health systems have many of the necessary ingredients to be successful in this initiative. Moreover, if this approach to care is to be widely adopted, and behaviour change achieved. the next generation of healthcare leaders and workers must be introduced to these concepts early in their training.
