New Health Department Initiative Helps Physicians Fill the Prevention Gap

February 1, 2010 - The Health Department's Primary Care Information Project (PCIP) today announced the launch of a new program to help primary-care physicians combat preventable health problems. Under the so-called Panel Management program, outreach specialists will work with physicians to identify patients in need of preventive health services such as cholesterol management or blood pressure control, and encourage them to make appointments for care and treatment. PCIP has equipped more than 1,700 New York City medical practices with electronic health records that highlight patients' health risks before they cause acute conditions such as heart attack or stroke. The new program, which is largely funded by Pfizer Inc., will help ensure that patients do not miss opportunities to act on this information and receive follow-up care.

Health care providers focus on patients when they come in for appointments, but many providers lack the resources to identify patients who don't seek recommended care. Closing this gap could prevent a great deal of needless death, disability and hospitalization. In 2006, there were over 120,000 preventable hospitalizations among New York City residents ages 18 years and older - hospitalizations that could have been avoided with appropriate treatment in a primary care setting. Under Take Care New York 2012, New York City's health policy blueprint, the City aims to cut preventable hospitalizations by 17 %. The Panel Management program will help achieve that goal.

"Instead of waiting for high-risk patients to seek treatment, the Panel Management program connects primary care doctors with New Yorkers who need ongoing care," said Dr. Thomas Farley, New York City Health Commissioner. "For example, of the 25% of New Yorkers who suffer from hypertension, less than half have their blood pressure controlled. Panel Management will help to address this gap."

"Panel Management moves health care from ‘you get it only if you come' to a patient-centered approach that reminds people to get screenings or treatment," said Dr. Amanda Parsons, the assistant health commissioner who leads PCIP. "Small medical practices often don't have the resources to provide this kind of outreach. This initiative uses existing technology to cross that barrier."

"This program reflects Pfizer's long-term commitment to New York City and even larger commitment to advancing patient care," said Dr. Freda Lewis-Hall, Pfizer's Chief Medical Officer. "By working collaboratively with our partners in the New York City Department of Health, we hope to develop more active approaches to primary care that help patients better manage their health and avoid costly illnesses."  

The Health Department will monitor medical practices in the Panel Management program to see how it affects the cost and quality of care and the satisfaction of patients. The agency has already tested the model at MS Family Medicine Health Care, a Queens-based practice, where an outreach specialist has helped Dr. Michele C. Reed maintain closer contact with at-risk patients. "Panel Management is now a vital part of our practice," said Dr. Reed. "As a physician, it's my job to look after all my patients, not just those who remember to schedule an appointment."

Besides improving patient health, the Panel Management model of health care could create new opportunities for skilled workers and help sustain job growth in the health-IT sector.

Physicians who want to adopt the Health Department's electronic health record, or join the Panel Management program, can find more information at