Health Information for Managing Demand

Chairperson:

James F. Fries, M.D.,Stanford University School of Medicine, Chairman, Healthtrac Inc.

Panelists:

David Gustafson, Ph.D., University of Wisconsin.

Donald W. Kemper, MPH, Healthwise, Inc.

Donald M. Vickery, M.D., Health Decisions International

• STATEMENT OF THE SUBJECT

The management of need and demand is a central requirement for organized systems of care, both to improve members' health and to moderate costs. This requires effective systems with proven results, and the integration of these systems into the overall information systems of the organized group.

• KEY ISSUES, INCLUDING THE ROLE OF TECHNOLOGY

How do we define a need and demand reduction program? How do need and demand reduction systems interface with the individual? What are the criteria for effectiveness of "new" treatment systems? How do these systems interface with more general medical information systems?

A theoretical structure encompassing information flow between need and demand reduction programs and organized systems of care has been developed. It encompasses the emerging role of technology in providing efficient programs and documenting their effectiveness, with particular reference to computer-individualized mail-delivered programs, the time-oriented computer data bank, and the electronic medical record.

Interactive computer systems are proving valuable for information and support of persons with specific medical conditions. Evaluations have demonstrated that interactive systems successfully impact health service use, drug compliance, and adherence to rehabilitation programs. Experiences with such systems suggest future applications for demand management.

• ROLES, RESPONSIBILITIES, AND PRIORITIES OF KEY SECTORS

1. Policy: Need and demand management should be presented as a high national priority, based on potential benefits to consumers, providers, organized systems of care, and the broader society.

2. Legislative: Include need and demand reduction programs as part of care benefits packages. Establish standards for such programs.

3. Providers: Need to provide organized support for need and demand reduction programs which partner with and augment personal medical services.

4. Patients: Need to see gain from programs in terms of better personal health, greater control over their lives, and enhanced dignity and autonomy.

5. Industry: Need to push the state-of-the-art in terms of more effective, lower cost programs and integration of these programs with provider, administrative, and health system goals and activities.

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