Care coordination and telehealth technology in promoting self-management among chronically ill patients.

With an increasingly complex healthcare system, the need to coordinate the care for chronically ill patient often goes unmet. This results in increased utilization of services at significant costs. In addition, providing patients with the tools to manage their own disease processes over the long term is also lacking in the healthcare environment. The Veterans Health Administration (VHA) approached these challenges by creating a Care Coordination program using technology to promote self management for veterans. Although a relatively new program, the Veterans Integrated Services Network (VISN) 7, has shown substantial gains in both decreasing the use of high cost care, such as emergency department (ED) visits and hospitalizations, as well as improving clinical outcomes with better glycemic control for patients with diabetes and improved lipid management for all patients.