Incorporating patient input into the design of a disease management program for COPD.

In the era of value-based payment contracts, there is increasing emphasis on disease management as a strategy for improving care quality and reducing costs. To design effective disease management programs, healthcare systems should understand the day-to-day experience of living with particular health conditions, and ensure that evidence-based services and interventions are adapted to align with the realities of patients' lives and their priorities. For healthcare systems operating with limited resources, there is a need for practical and small-scale approaches for collecting and using patient input as part of program design and operations. This case study describes a targeted interview process that Cambridge Health Alliance (CHA) used to gather patient input during the design of a disease management program for chronic obstructive pulmonary disease. The patient perspectives gathered through the interviews influenced several aspects of the program design. The key lessons from CHA's experience are: 1) A small-scale approach with cycles of 5-10 interviews can produce valuable insights for program design; 2) Short patient vignettes can be used to summarize patient data in a simple and compelling format; and 3) Clinicians' perspectives are critical for interpreting patient input and extracting information that is most likely to be useful for program design. CHA's approach provides an example of a systematic and practical process for gathering patient input that other healthcare systems can adapt to their local contexts.