SPECIAL ARTICLE

ABSTRACT Chronic disease is a demographic reality across the world and health care systems need to readjust their approach to care accordingly. Such a transformation will require rethinking almost every aspect of care as we know it and the roles of health care practitioners will need to change, as many tasks can now be accomplished by others. Concurrently, patients must become active and productive partners in their care. Time concepts must also be shifted from events to episodes, wherein success over the long term will best be measured by compar-ing actual clinical courses to what would have occurred in the absence of good care. The philosophy of care should reflect a willingness to invest in care at the front end in expectation of later benefits. Informa-tion technology is central to these changes, both in the sharing of information about clinical status and to alerting caregivers to early signs of clinical change. These necessary developments will not come easily