CHRONIC DISEASE MANAGEMENT

The increased incidence of chronic diseases such as diabetes, congestive heart failure, asthma, depression, and others presents a unique challenge to HHC's health care system and its resources. HHC has responded to the burgeoning chronic disease population by developing ambulatory care teams focused on improving clinical outcomes for patients. Utilizing improvement concepts from the Institute of Health Care Improvement and the Chronic Care Model developed by Dr. Edward H. Wagner*, Director of Improving Chronic Illness Care, these teams continue to achieve significant improvements in clinical outcomes.

HHC Goals for Chronic Disease Management:

Maximize the length and quality of life for people with chronic illness and satisfy patient and caregiver needs in a cost-effective manner
Reduce the complications of chronic illnesses often disproportionately seen in minority and low income populations
Assure the delivery of evidence-based clinical care and strong support for self-management
Meet and surpass national benchmarks of quality
Encourage innovation; using resources differently

*Improving Chronic Illness Care (ICIC) is a national program of The Robert Wood Johnson Foundation based in Seattle at the MacColl Institute for Healthcare Innovation, at Group Health Cooperative.