Draft standards for the new Joint Commission on Accreditation of Healthcare Organization's (JCAHO) Disease-Specific Care (DSC) Certification Program are now available on the JCAHO website.

The standards have been posted in anticipation of a February launch of the program to improve the quality, safety and effectiveness of comprehensive treatments and services for more than 105 million Americans suffering from at least one chronic condition. The first DSC review is scheduled for February 14 in Southern California.

JCAHO will offer DSC certification for disease management and chronic care services that are provided by health plans, disease management service companies, hospitals and other care delivery settings. The evaluation and resulting certification decision will be based on:

• an assessment of compliance with consensus-based standards,
• the demonstrated effective use of established clinical guidelines to manage and optimize care, and
• the measurement and improvement of health outcomes.

More than 70,000 individuals, including representatives from consumer advocacy groups, disease management organizations and JCAHO-accredited organizations were invited by JCAHO to comment on the draft standards last month. The review included questions relating to 1) the relevance of the draft standards to disease-specific care service, 2) the identification of standards that needed to be added or deleted from the draft, 3) the potential value of the JCAHO Certification Program for organizations and 4) whether the tracking and reporting of sentinel events is relevant to disease management.

JCAHO concurrently conducted pilot testing at a variety of sites, including hospital-based programs, county health services within an integrated delivery system, ambulatory care clinics, anticoagulation therapy centers, primary care physician groups, and disease management service organizations. The County of Los Angeles Department of Health Services, Mayo Clinic, and WellStar Health System were among the sites that participated in the pilot testing.

In addition to the field review of standards and pilot testing, the Joint Commission engaged more than 25 health care organizations representing hospitals, health plans, disease management organizations, integrated delivery systems and primary health care providers for input on the development of a meaningful evaluation program for disease management services.

During 2001, JCAHO tapped clinical experts from the National Chronic Care Consortium, the Disease Management Association of America, the Disease Management Purchasing Consortium and other leadership organizations in health care to assist in the development of the new DSC program.

JCAHO is now reviewing results of the field review and making revisions to ensure that the program is diverse enough to meet the needs of the various kinds of organizations offering disease-specific care services. JCAHO's Board of Commissioners is expected to give final approval to the DSC standards early this month.

The impetus for the JCAHO DSC Certification Program comes from increasing attention on the care of patients with chronic conditions among providers, purchasers, payers, policymakers and health care consumers. However, despite the rapid growth of disease-specific care efforts, there has heretofore, been no nationally accepted standards or formal oversight for these services.

The recent Institute of Medicine report, "Crossing the Quality Chasm," recognized that chronic conditions are now the leading cause of morbidity, disability and death, and account for the majority of health care expenditures. Disease-specific services target individuals and populations that are suffering from or are at risk for specific chronic illnesses and focus on improving the patient's health status through an integrated care management process.

Click here to see the draft standards document.