Patients with chronic illnesses form a substantial proportion of the population and the number of these patients continues to rise. Reports indicate that come 2020, the U.S will have 157 million people living with chronic illnesses (Solomon, 2008). This calls for proper chronic illness management systems. This paper gives a summary of two chronic illness management systems; the chronic care model (CCM) by Wagner and the chronic disease self management by Patrick McGowan.
CCM model by Wagner involves two overlapping realms, the community and the healthcare system. The model argues that “when activated patients interact with a prepared, proactive practice team, the result is improved functional and clinical outcomes” (Barr et al., 2003). The foundation of CCM is the symbiotic relationships between patients who are fully involved in the management of their health, and the care providers. This care takes place in a health care system that utilizes community resources. Four elements of the care model influence the ability to deliver effective chronic illness care at the clinical level. “Self management support, delivery system design, decision support and clinical information systems” constitute the four elements of the care model (Group Health Cooperative, 2009).
CCM aims at giving care that is safe, effective, timely, patient-centered, efficient and equitable (Group Health Cooperative, 2009). Each element has its main objectives. Self management support strives to empower and prepare patients to manage their health and healthcare. The delivery system assures the provision of effective, efficient clinical care and self management support. Decision support promotes clinical care that is consistent with scientific evidence and patient preferences. On the other hand, clinical information systems ensure proper organization of patients’ and population data to facilitate efficient and effective care.
In addition, CCM includes health care organization culture and mechanisms that promote safe, high quality care. Moreover, the model calls for the mobilization of community resources to meet the needs of the patients. This is achieved through the encouragement of patients to engage in effective community programs and advocacy for policies to improve patient care. This can also be achieved through the formation of partnerships with community organizations to support and develop interventions that fill gaps in needed services.
The chronic disease self management model emphasizes on the need for self management in dealing with a disease, and the inculcation of personal skills for health and wellness (Barr et al., 2003). The aim of this model is to see individuals undertake tasks that allow them to live well with their chronic health conditions. The model also empowers patients so that they can have the confidence to deal with medical, role and emotional management of their conditions.
According to McGowan (2007), self management can be seen as a process or an outcome. When considered as a process, then the emphasis is on the type of training (self management education and preparation) given to patients with chronic illnesses. Thus, the training includes mastery learning and problem solving. The training is provided by healthcare professionals and sometimes trained lay persons. When self management is considered as an outcome, it usually connotes people with chronic health conditions having achieved the knowledge, skills and confidence to manage their health and engage in particular behaviors relating to medical, role and emotional management (McGowan, 2007). These outcome behaviors and confidence usually arise from the training process. Self management support involves patient education and self management education. Both types of education are essential in assisting the individual achieve the best quality of life and independence.
In conclusion, it can be noted that Wagner model involves symbiotic relationships between patients who are actively involved in the management of their health, and the care team members. It involves two overlapping realms, the community and the healthcare system with self management support as one of the four essential components within the healthcare system. On the other hand, self management support model by McGowan emphasizes on the importance of self management in dealing with a disease, and the inculcation of personal skills for health and wellness (Barr, et al., 2003).
References
Barr et al. (2003). The Expanded Chronic Care Model: An intergareation of Concepts and Strategies from Population Health Promotion and the Chronic Care Model. Healthcare Quaterly, 7(I), 73-82. Web.
Group Health Cooperative. (2009). Summary of Wagner Chronic Care Model. Web.
McGowan, P. (2007). Self Management: A Background Paper. Web.
Solomon, M. (2008). Information Technology to Support Self Management in Chronic Care: A Systematic Review. Adis Data Information , 16(6), 391-401.