Development and implementation of clinical management guidelines.

Memorial Sloan-Kettering Cancer Center is in the process of developing a disease management system that is prospective, longitudinal, and has built-in outcome measures. These will include not only the traditional clinical outcomes of response and toxicity but also outcome measures related to patients' feelings about the healthcare environment, as well as costs. The system has three essential features: (1) standards of care, (2) information technology to integrate data, and (3) central coordination of the program through the establishment of disease management teams. This article highlights the key features of the system.