Disease management involves a holistic approach in which healthcare professionals work together to effect an optimal outcome for a particular patient with a particular disease. The environment needed for optimal disease management programmes includes a multidisciplinary culture of cooperation, communication and coordination, a clinical champion, an administrative champion, enough time to do disease management correctly, enough support to do it right, computerized information systems, examination of the total patient continuum and not component management, and use of multiple sites to obtain larger sample sizes. Disease management goes beyond outcomes research, it goes beyond guidelines development, and it goes beyond randomized controlled trials (RCTs).