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.
Chen L, Chubak J, Boudreau DM, Barlow WE, Weiss NS, Li CI. Diabetes treatments and risks of adverse breast cancer outcomes among early stage breast cancer patients: a SEER-Medicare analysis. Cancer Res. 2017 Nov 1;77(21):6033-6041. doi: 10.1158/0008-5472.CAN-17-0687. Epub 2017 Sep 21. PubMed
Lim CY, Berry ABL, Hirsch T, Hartzler AL, Wagner EH, Ludman EJ, Ralston JD. Understanding what is most important to individuals with multiple chronic conditions: a qualitative study of patient's perspectives. J Gen Intern Med. 2017 Aug 28. doi: 10.1007/s11606-017-4154-3. [Epub ahead of print]. PubMed
Tang HJ, McCurry SM, Pike KC, Von Korff M, Vitiello MV. Differential predictors of nighttime and daytime sleep complaints in older adults with comorbid insomnia and osteoarthritis pain. J Psychosom Res. 2017 Sep;100:22-28. doi: 10.1016/j.jpsychores.2017.06.020. Epub 2017 Jul 1. PubMed
Rohrer Vitek CR, Abul-Husn NS, Connolly JJ, Hartzler AL, Kitchner T, Peterson JF, Rasmussen LV, Smith ME, Stallings S, Williams MS, Wolf WA, Prows CA. Healthcare provider education to support integration of pharmacogenomics in practice: the eMERGE network experience. Pharmacogenomics. 2017;18(10):1013-1025. doi: 10.2217/pgs-2017-0038. Epub 2017 Jun 22. PubMed
Tisminetzky M, Bayliss EA, Magaziner JS, Allore HG, Anzuoni K, Boyd CM, Gill TM, Go AS, Greenspan SL, Hanson LR, Hornbrook MC, Kitzman DW, Larson EB, Naylor MD, Shirley BE, Tai-Seale M, Teri L, Tinetti ME, Whitson HE, Gurwitz J. Research priorities to advance the science of multiple chronic conditions in older adults. J Am Geriatrics Soc, doi: 10.1111/jgs.14943. [Epub ahead of print 2017, May 26].
![]() Michael L. Parchman, MD, MPHSenior Investigator, ACT Center |
![]() Beverly B. Green, MD, MPHSenior Investigator |
![]() James D. Ralston, MD, MPHSenior Investigator |
![]() Paula Lozano, MD, MPHSenior Investigator |
![]() Katie Coleman, MSPHDirector, Collaborative Science; Director, ACT Center |
![]() Gregory E. Simon, MD, MPHSenior Investigator |
![]() Katharine A. Bradley, MD, MPHSenior Investigator |
![]() Jennifer B. McClure, PhDDirector, Investigative Science |
![]() Dori E. Rosenberg, PhD, MPHAssociate Investigator |
![]() Aruna Kamineni, PhD, MPHAssistant Investigator |
![]() Ben Balderson, PhDSenior Collaborative Scientist |
![]() Joseph E. Glass, PhD, MSWAssociate Investigator |
![]() Yu-Ru Su, PhDAssistant 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 |
![]() Kelsey Stefanik-Guizlo, MPHCollaborative 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