Involving eHealth: How health care leaders may envelop chronic care management strategies with health information exchange directives

As chronic diseases are becoming a rapidly growing problem in the world, methods to manage and present medical information both to care providers and patients require several avenues of thought. Janet Marchibroda, MBA is the chief executive officer of the eHealth Initiative and its Foundation — both independent, national non-profit organizations based in Washington, D.C., whose missions are to improve the quality, safety, and efficiency of health care through information and information technology.

Janet Marchibroda has devised three plans to bring together chronic care management strategies with health information exchange directives: 1) Leveraging Health Information Exchange Efforts for New Chronic Care Management Programs, 2) Augmenting Existing Chronic Care Management Strategies with New Data Sets and Services from the Health Information Exchange, and 3) Extending the Ability to Communicate with Care Providers and Patients. To summarize these three strategies, the first implies by asking those involved in chronic care management what tools are already existent or lacking, e.g. ongoing health information exchange initiatives, if any; types of data being exchanged and to whom, and so forth. In other words, a system must be put in place to set a helping “leverage” in managing chronic diseases. Secondly, the next paradigm focuses on improving an already existing chronic disease management initiative. Missing data elements may be included here, as well as methods to improve the measurement of quality of care and cost effectiveness. Thirdly, the final theme emphasizes an active patient-practitioner relationship, and methods should be identified for the patients themselves to be actively involved with the regimen of treating their diagnoses and preventing the onset of worsening or secondary conditions.

With this in mind, there are also some recommendations that may improve chronic disease management. Databases of eHealth ought to have a storage of health indicators, determinants, and conditions. Certain conditions could each have a specific variable (with a proper categorization, i.e. what type of condition is it, e.g. autoimmune, etc.) assigned to them and a constantly updated list of  symptoms (entered and updated by the care providers). The database could draw data of symptoms from each patient with a specific condition, and this should be accessible to health care providers to give them more clues for an accurate diagnosis and for the prevention of misdiagnosis. Finally, each of these specific conditions assigned with a variable should have a list of viable treatments and its strengths and weaknesses. These treatments could be taken from studies done in medical databases, i.e. PubMed, The Lancet, and contain and explore as many treatments as possible — both conventional and unconventional. The care provider informs the patient and/or family of the patient not only with the type of treatment they deem the most effective, but also viable alternatives. These methods of managing of eHealth may lead to effective treatment and prevention of chronic diseases.


Marchibroda JM (2008) The Impact of Health Information Technology on Collaborative Chronic Care Management. Journal of Managed Care Pharmacy 14:2, s3-10. Retrieved Apr 27 from:


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About Adrian Levitsky

Adrian is a Research Technician and Doctoral Student at Karolinska Institutet's ClinTRID department for Inflammatory (Autoimmune) Disease research. He is a blogger for the Silverevolution initiative by ACCESS Health International. He defended his Masters thesis in Global Health at Karolinska and worked together with the CAMbrella project's Swedish team ( in analyzing global key stakeholders of Complementary and Alternative Medicine (CAM) and Traditional Medicine (TM). He has an avid interest in research. Particularly, he wishes to research CAM/TM and promulgate an evidence base for the potential effectiveness of integrative care -- as this communication still is lacking globally. Adrian has a background starting as a pilot at Embry-Riddle Aeronautical University, which later evolved to studying Human Factors Psychology with a drive to understand how man and machine work together. This field often focuses heavily on research and involves testing available theories or finding new solutions to prevent work-related injuries, reduce stress, and emphasize usability/ergonomics. Teaching English in South Korea made him realize the need for innovation and imagination for all school curricula in order to solve today’s dilemmas.

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