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Reorganizing Chronic Care Delivery Health Affairs, January/February 2009; 28(1): 63 [Extract] [Full Text] [PDF] [Reprints & Permissions]

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Challenges In Providing High-Quality Chronic Care

Arvind R. Cavale   ( 19 January 2009 )

Challenges In Providing High-Quality Chronic Care 19 January 2009
Arvind R. Cavale, MD, FACE, FACP Private Practice Send comment to journal: Re: Challenges In Providing High-Quality Chronic Care mdllcoffice{at}gmail.com Arvind R. Cavale	Having toiled for years in developing a workable "continuous care model" for managing diabetes via a solo practice format, I find this discussion very fascinating. However, most examples cited involve rather large institutions with potential redundant staff to provide services in the "chronic care model". It is yet to be documented to be effective in a small office-based setting, where a majority of Americans receive their care for chronic diseases. We have demonstrated that by using IT effectively, a small group of well-trained, motivated staff can effectively manage chronic diseases like diabetes, while improving patients' self-care abilities, responsibility, and motivation along the way. Unfortunately, there is no financial or other type of recognition of such efforts for practices that are not part of a large medical center/system. We hope that Health Affairs (via current publications) can increase awareness about successful chronic care management processes that already exist in the community.