Improving Chronic Illness Care

 PANDA, PUBLIC HEALTHCARE / CHRONIC ILLNESS

Improving Chronic Illness Care (ICIC), a national program of The Robert Wood Johnson Foundation, is dedicated to the idea that United States health care can do better. According to the ICIC, chronic conditions are a fact of life for an estimated 99 million Americans. Of these, 41 million people have their daily activities limited in some way because of their condition, and 12 million are unable to live independently.1

In addition, the results of surveys conducted by the Johns Hopkins Bloomberg School of Public Health found that chronic conditions are the leading reason people seek medical care and that the treatment of chronic conditions accounts for 78 percent of all health expenditures in the United States. 2

Dr. Gerard Anderson, Professor of Health Policy and Management and International Health at the School of Public Health at Johns Hopkins, notes,  “There is widespread agreement that the current medical system is not meeting the needs of people with chronic medical conditions. Changes in how medical care is financed and delivered are necessary to respond to these concerns. Overall health care costs can be lowered through better care delivery.”   2

Our Association specialty is Chronic Fatigue Syndrome, an illness affecting 800,000 people nationwide. This number pales in comparison to the millions of people who suffer from chronic conditions with a major common symptom of daily exhaustion. Through our experience and research, we found that diagnosis and treatment is difficult and expensive for many of these patients, and for their primary care doctors.

Literally hundreds of illnesses cause fatigue. Millions of research dollars are spent each year to enable medical scientists to further understand and name 21^st century illnesses.  In the meantime, trench MD’s have no practice guidelines for fatigue.  How is a primary care MD going to diagnose and treat? Are there alternatives for patients? Those with longstanding fatigue, travel from doctor to doctor. Out of desperation, patients find “Magic Bullet” consultants who peddle everything from online diagnosis to a myriad of pills.

In Madison, we can do better. In Wisconsin, we can do better. To create, implement and support a Fatigue Specialty Center is our long-term project.  We propose that a Fatigue consultation center, like a Pain Clinic, would provide a necessary resource to doctors, an invaluable resource for patients, and at the same time address cost containment.

After careful review of the Robert Wood Johnson Chronic Care Model, we drafted a program for the Fatigue Consultation Center.  This model combines medical and social services into six components as follows:  Quality of life assessment, diagnosis, treatment/intervention, prevention, self-management, and medical education.

 We are ready to share ideas and look at our community resources.

Project Goals (02/04)

Working toward implementation

1. Explore medical and social community resources.
2. Gauge level and type of support from existing agencies.
3. Flood medical, social service and patient consumers with information about the      October 2004 Madison conference opportunity for training, Continuing Medical Education, and simple awareness.
4.  Meet with potential collaborators after the conference is over.
5. Carefully determine if this clinic will be freestanding or collaborative with an existing medical facility.