The quotes from project managers E and A reflect a change
mentioned by several project managers regarding how clinicians
thought about and interacted with patients. Project managers
stated that this change in thinking reflected a shift from the
provision of general advice to a focus on patient-centered and
The aforementioned monitoring process reflects the expansion
of communication within DMPs, from a one-on-one providerpatient
interaction during an annual check-up to communication
among multiple caregivers in regular contact with patients at the
individual and group levels. Project managers stressed the
importance of group contact because patients could learn from
and support one another