What do diabetes, back pain, depression, and heart disease have in common? They're among a host of chronic health problems and disabilities that have traditionally received too little attention from health care systems — until serious complications develop. Modern medicine tends to focus on detecting and treating acute problems, leaving fewer resources for the needs of patients with chronic illnesses, which may be less urgent but are equally important.
Our population is aging rapidly, and people with chronic conditions are living longer. Chronic conditions now affect more than 145 million Americans. About half of Americans over 65 — our nation’s fastest-growing segment — have at least 2 chronic conditions. As our need for improved chronic care grows, health care delivery systems are trying to correct the many deficiencies in current management of chronic diseases.
“Much of our work now focuses on finding ways to give organizations the support and tools they need to build high-functioning health care teams that can engage patients, improving the quality and outcomes of their care,” says Michael Parchman, MD, MPH, senior investigator at Kaiser Permanente Washington Health Research Institute (KPWHRI) and a researcher within its Center for Accelerating Care Transformation (ACT Center).
"Meeting the complex needs of patients with chronic illness or impairment is the single greatest challenge facing organized medical practice," says Ed Wagner, MD, MPH, founder of the MacColl Center for Health Care Innovation, which joined with Kaiser Permanente Washington’s Learning Health System Program to form the ACT Center.
For over 2 decades, KPWHRI scientists have been developing, implementing, and promoting better models of care for chronic illness. Widely recognized for its refinement and dissemination of the Chronic Care Model, the ACT Center continues to work with providers nationwide to develop strategies and tools for health care systems seeking to improve chronic illness care.
Such resources are then shared globally through active engagement with international organizations developing guidance and care recommendations. Providers worldwide continue to adapt materials such as the ACT Center’s Patient Assessment of Chronic Illness Care and Patient-Centered Medical Home Assessment surveys.
Hebert PL, Sisk JE, Wang JJ, Tuzzio L, Casabianca JM, Chassin MR, Horowitz C, McLaughlin MA. Cost-effectiveness of nurse-led disease management for heart failure in an ethnically diverse urban community. Ann Intern Med. 2008;149(8):540-8. PubMed
Coleman K, Mattke S, Perrault PJ, Wagner EH. Untangling practice redesign from disease management: how do we best care for the chronically ill? Annu Rev Public Health. 2009;30:385-408. Epub 2008 Oct 16. PubMed
Thomas MC, Dublin S, Kaplan RC, Glazer NL, Lumley T, Longstreth WT Jr, Smith NL, Psaty BM, Siscovick DS, Heckbert SR. Blood pressure control and risk of incident atrial fibrillation. Am J Hypertens. 2008;21(10):1111-6. Epub 2008 Aug 28. PubMed
Von Korff M, Saunders K, Thomas Ray G, Boudreau D, Campbell C, Merrill J, Sullivan MD, Rutter CM, Silverberg MJ, Banta-Green C, Weisner C. De facto long-term opioid therapy for noncancer pain. Clin J Pain. 2008;24(6):521-7. PubMed
Katon WJ, Russo JE, Von Korff M, Lin EH, Ludman E, Ciechanowski PS. Long-term effects on medical costs of improving depression outcomes in patients with depression and diabetes. Diabetes Care. 2008;31(6):1155-9. Epub 2008 Mar 10. PubMed
Beverly B. Green, MD, MPHSenior Investigator |
James D. Ralston, MD, MPHSenior Investigator |
Paula Lozano, MD, MPHSenior Investigator; Director, ACT Center |
Katie Coleman, MSPHDirector, ACT Center |
Gregory E. Simon, MD, MPHSenior Investigator |
Katharine A. Bradley, MD, MPHSenior Investigator |
Jennifer B. McClure, PhDDirector, Investigative Science |
Dori E. Rosenberg, PhD, MPHSenior Investigator |
Ben Balderson, PhDSenior Collaborative Scientist |
Joseph E. Glass, PhD, MSWAssociate Investigator |
Yu-Ru Su, PhDAssociate Biostatistics Investigator |
Chloe Krakauer, PhDCollaborative Biostatistician |
Mikael Anne Greenwood-Hickman, MPHCollaborative Scientist |
Laurel Hansell, MA, MPHCollaborative Scientist |
Claire Allen, MPHManager, Collaborative Science |
Morgan Justice, MACollaborative Scientist |
Laura-Mae Baldwin, MD, MPH
Professor, Department of Family Medicine
University of Washington
Linda LeResche, ScD
Associate Dean for Research, School of Dentistry
Professor, Oral Medicine
University of Washington