We are very pleased to present this issue of HealthcarePapers on chronic disease prevention and management (CDPM). The topic of CDPM is increasingly important as the population is living longer and those extra years of life are often accompanied by chronic diseases. There is no shortage of literature internationally on this subject, with specific recommendations about the care and treatment of diseases such as heart failure, arthritis, diabetes, cancers and so on. One conclusion from this literature is that health systems are generally not designed to meet the needs of the chronically ill patient. Of particular note is the acknowledgement that services for chronic diseases, from prevention to treatment to palliative care, are not integrated. Multiple providers are frequently involved, and it is easy for patients to fall between the cracks.

The lead paper on this important issue was written by Matthew Morgan and Nick Zamora, of the Courtyard Group, and Michael Hindmarsh, president of Hindsight Healthcare Strategies, Group Health Cooperative. These authors highlight the growing gap between recommended care for chronic illnesses and the actual care individuals receive. They go on to identify some best practices and then recommend strategies for rectifying the chronic care dilemma in Canada. This paper provides an excellent summary of the key issues for CDPM and some urgent strategies for the future.

The lead paper is followed by outstanding responses from many individuals who contribute to a rich debate about steps to be taken. As identified by Morgan et al., there are five main themes that emerge: the need for leadership; the shared responsibility between payers, providers and consumers; the need for a population health perspective in the design of health systems; the essentiality of informatics including electronic health records; and the accessibility of data to drive decision-making and, hence, performance.

I have no doubt that this is one of those special issues of HealthcarePapers that you will want to keep on your bookshelf and read several times as the problems of CDPM become more critical in everyday life.

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