such material could be provided at physicians' offices, which would also help facilitate provider-patient communication.

Invest in Educational Programs

Although the strengths of the educational programs of certain managed care organizations have been significantly enhanced, most such organizations have limited or suboptimum educational and outreach efforts in terms of emerging infections. Managed care organizations have the responsibility to educate providers regarding their critical role in accurate infectious disease reporting. Managed care organizations should invest in educational efforts on emerging infections and initiate partnerships with buyers to identify key educational program opportunities and increase the level of awareness of emerging infections beyond antimicrobial resistance.

Summary

The workshop participants recognized that managed care organizations could have positive impacts on education efforts. The guidelines developed by AAHP for the participation of member plans in research and demonstration projects is one example of the way in which coordinated efforts to develop and implement guidelines have been successful. In addition, several plans have collaborated in their efforts to identify problems and change physician behavior, for example, in the prescribing of antibiotics. The access to large numbers of physicians, patients, and families through managed care could be useful in other education and outreach efforts. However, not all managed care organizations have the same capability to participate in educational and outreach programs. Continued action and investment by NIH and CDC will be important to broadening the base of cooperation.

In contrast, several characteristics of managed care could have a negative effect on education and outreach efforts. Primarily, infectious diseases are often a health concern among the populations that are not covered by managed care organizations. Biased enrollment into managed care organizations often results in managed care physicians having less exposure to emerging infections, and the nature of their practice gives them fewer opportunities for consultation with specialists and reduced incentives for continuing education in the current diagnosis and therapy of infections diseases.

Panelists at the workshop felt that there was a need for increased investment in education and outreach for all health professionals in the area of emerging infections and the closely related area of antimicrobial resistance. NIH, CDC, and the pharmaceutical industry are pursuing multidisciplinary approaches to educating medical and public health professionals, but more programs are needed. Major purchasers of managed care also have an important role to play in



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