Chronic disease is a demographic reality across the
world and health care systems need to readjust their approach to care
accordingly. Such a transformation will require rethinking almost every
aspect of care as we know it and the roles of health care practitioners
will need to change, as many tasks can now be accomplished by others.
Concurrently, patients must become active and productive partners in
their care. Time concepts must also be shifted from events to episodes,
wherein success over the long term will best be measured by comparing actual clinical courses to what would have occurred in the absence
of good care. The philosophy of care should reflect a willingness to
invest in care at the front end in expectation of later benefits. Information technology is central to these changes, both in the sharing of
information about clinical status and to alerting caregivers to early signs
of clinical change. These necessary developments will not come easily.

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