Improving outcomes in chronic illness.

Usual medical care often fails to meet the needs of chronically ill patients, even in managed, integrated delivery systems. The medical literature suggests strategies to improve outcomes in these patients. Effective interventions tend to fall into one of five areas: the use of a protocol, reorganization of practice systems and provider roles, improved patient education, increased access to expertise, and greater availability of clinical information. The challenge is to organize these components into an integrated system of chronic illness care.