This week in class our group presented on the different theoretical and practical treatment frameworks that are currently implemented to satisfy the needs of those with chronic illness. One of the two programs that were extensively discussed was that of Kaiser-Permanent, an “integrated manage care organization” founded in 1945 in Oakland, California, and that of the NHS (National Health System) in the England, 1946. It is evident that the existence of both sanitation organs has been around for almost the same length of time. But that is beside the fact; the purpose of this article is to discuss the components of these prestigious sanitation programs that have been admired by the international community.
These programs follows the CCM (Chronic Care Model) that Wagner developed which include six main factors that act in the betterment of chronic disease health care. These are outlined in Wagner’s diagram as the following: self-management, delivery system design, decision support, clinical information system (CIT –communication information technology), informed/active patient, prepared practice team. Tsai’s research shows that simply implementing only one of the six CCM components shows to impose beneficial effects in the treatment of chronic illnesses. Kaiser-Permanent and NHS have been able to implement successful programs based off of Wagner’s six components. This is what makes them today world renowned health providers regarding chronic illness. Although there is a catch to this beautiful image, there always is when something looks too good to be true.
After studying these programs it occurred to me that such system might not be effective in a developing country, nor in a country with a culture opposite to that of westerners. Not only is there a dependence on IT (Information Technology) in the process of patient education, but also in the sharing of information between physicians. Such interface has been extensively argued to be an efficient and important aspect in patient-physician communication, data sharing, treatment, decision making, and education. But what we do not take into consideration is that only 1/3 of the world has internet access, according to BBC radio. Therefore what is expected from developing countries, are they not able to successfully offer adequate services?
There is the possibility for developing countries to follow models like that if Kaiser´s to offer adequate care for those with chronic illness. Face-to-face communication, community information sessions, patient-to-patient communication are means to solve the lack of IT that a developing country might face. There is also the possibility that there is IT tools available, but that does not result to computer proficiency. Ideally CCM concepts sould be adapted to fit the profile of different countries and their economy, culture, and disease prevalence. Concluding, the take home message is that before admiring these models, it is crucial to take into consideration the fact that each location has its own context.