Improving Population Health Through Team-Based Panel Management: Comment on “Electronic Medical Record Reminders and Panel Management to Improve Primary Care of Elderly Patients”

A new concept is spreading rapidly across primary care practices: population management, also known as panel management. Panel management involves identifying and reaching out to patients—in the panel of a primary care practice or a primary care practitioner—who have unmet preventive and chronic condition care needs.¹

Panel management can be viewed at 2 levels: as a fundamental culture change and as a set of operational details. The culture shift requires practitioners to think beyond the patients scheduled for this week's appointments and to assume responsibility for the health of all the patients in their panels, whether or not the patients seek care. The changes in the day-to-day function of the medical practice require a staff person to periodically review the clinical registry, to identify care gaps (deficiencies in preventive or chronic condition care), and to arrange for patients to address those care gaps. Examples of care gaps are a 55-year-old woman failing to have a mammogram for 4 years or a patient with diabetes who is overdue for a hemoglobin A_1c or low-density lipoprotein cholesterol laboratory test or for a foot or eye examination.