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American Journal of Medical Quality
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The Introduction of Ambulatory Electrocardiographic Monitoring for the Diagnosis and Management of Myocardial Ischemia

Michael P. Corder, M.D., M.H.A., F.A.C.P., F.A.C.M.Q.

Heritage Medical Systems and Bakersfield Family Medical Center, Bakersfield, California

Joseph L. Monaco, P.A.-C., F.A.C.P.E

Heritage Medical Systems and Bakersfield Family Medical Center, Bakersfield, California

Teri Kraf, R.N., M.H.A.

Heritage Medical Systems and Bakersfield Family Medical Center, Bakersfield, California

Richard I. Levin, M.D., F.A.C.P., F.A.C.C

Heritage Medical Systems and Bakersfield Family Medical Center, Bakersfield, California

We report on the introduction of a new technology and a new method for the management of chronic coronary artery disease into a managed care environment. The introduction incurred substantial resistance from subspecialty consultants, primary care physicians, and top management. Strategies were developed to overcome these resistances. Modification of the program as well as the development of incentives occurred. These measures continue to evolve. The program, to date, has achieved approximately 50% penetration. The demonstration of better health outcomes and financial savings will almost certainly temper the resistance encountered from all three groups identified.

American Journal of Medical Quality, Vol. 12, No. 3, 169-174 (1997)
DOI: 10.1177/106286069701200307
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