Disease management. The heat and headaches over retooling patient care create hard labor.

Ken Gross and his colleagues at Group Health Cooperative of Puget Sound are rearranging the ingredients of patient care for 13,000 diabetics. The process they're using--known as disease management (and a host of other names), is reworking the care process for patients across the country, but it takes a lot of hard work, and some ingenuity.