
Disease Management (DM) is a patient-centric, coordinated care process for patients with specific health conditions, particularly chronic conditions and conditions that have a significant self-care component. DM programs include data mining processes to identify high-risk patients within a population; use of evidence-based medical practice guidelines to support and treat individual patients; and a coordinated, data-informed system of patient outreach, feedback, and response.
DM is a proactive care coordination process that is commonly used to control or reverse the effects of chronic health conditions. In the past decade, the emphasis of DM has shifted from a strictly disease-centric approach, where separate DM programs were tailored to single chronic illnesses, to one that is more patient-centric i.e., programs are tailored more to individual patient needs and better accommodate patients with multiple health challenges.