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SAN FRANCISCO -- Teaching employees to manage diseases and use demand-management services that provide health care information will yield a happier, healthi-er workforce, according to an expert.

Disease and demand management won't push aside current managed care practices, as some have suggested, but they will find a place alongside them, said Joan Siegel Birnbaum, director of marketing at Express Scripts Inc., a Maryland Heights, Mo., company that provides the services.

"Disease and demand management are part of managed care techniques," she told an audience at the Self-Insurance Institute of America's conference last month in San Francisco. "Managed care isn't moving aside; it's just incorporating some different kinds of services for you."

Disease and demand management programs are set up to teach employees how to better care for themselves.

Disease management techniques show those with long-term ailments how to control their conditions. A diabetic, for example, is taught how to control the disease through diet, exercise and prescription medication.

Demand management programs provide an employee with services such as access through a toll-free call to a nurse who can answer medical questions and provide guidance on whether self-care or a physician's care is needed.

The results of disease and demand management programs are a healthier work force, according to Ms. Birnbaum, along with lower medical costs.

She said savings show up because callers often choose a less costly health care option than they would have had they not been counseled.

When a patient does make the call, the program should provide an array of services, Ms. Birnbaum pointed out. Those include:

* Telephone access to a registered nurse and a pharmacist. Access to a pharmacist is important because he or she can help determine, for example, whether the side effects of a medication are causing a medical problem.

* Availability of a "live person" at any time and not a recorded message or answering service.

* Capabilities to assist the hearing-impaired and people who speak other languages.

* Computerized medical records that allow immediate entry of information.

* An online clinical data warehouse that allows a health counselor to speak on thousands of different topics and print out information to send to the caller.

* A system that allows a caller to retrieve information on a topic without consulting a counselor. Some callers might not want

to talk about sensitive medical conditions, Ms. Birnbaum explained.

* Follow-up calls to determine how the patient is doing and if other services are needed.

"This is not the future, this is now," Ms. Birnbaum said of disease and demand management programs. "These kinds of products and these kinds of services are available now. And they're a great way to improve the quality of life, provide a lot to your member satisfaction and minimize costs."

Brenda Haalboom, director of health management services at Express Scripts, also participated in the session.

The session moderator was Lynn Jennings, owner of Excess & Stop Loss Underwriters Inc. in Lake Mary, Fla.