Table 5.

Description of Elements of ICCC

Element	Description
Support a paradigm shift	A new shift will dramatically advance efforts to solve the problem of managing diverse patient demands given limited resources. Health care systems can maximize their returns from scarce and seemingly non-existent resources by shifting their services to encompass care for chronic conditions.
Manage political environment	Policy-making and service planning inevitably occur in a political context. Political decision-makers, health care leaders, patients, families, and community members, as well as organizations that represent them, need to be considered. It is crucial to initiate bi-directional information sharing and to build consensus and political commitment among stakeholders at each stage (Wielawski, 2011; WHO, 2002).
Build integrated health care	Care for chronic conditions needs integration to ensure shared information across settings and providers, and across time. Integration also includes coordinating financing across different arms of health care including prevention efforts and incorporating community resources that can leverage overall health care services. The outcome of integrated services is improved health, less waste, less inefficiency and a less frustrating experience for patients.
Align sectoral policies for health	The policies of all sectors need to be analyzed and aligned to maximize health outcomes. Health care can be and should be aligned with labor practices (e.g., assuring safe work contexts), agricultural regulations (e.g., overseeing pesticide use), education (e.g., teaching health promotion in schools), and broader legislative frameworks (WHO, 2002).
Use healthcare personnel more effectively	Health care providers, public health personnel and those who support health care organizations need new, team care models and evidence-based skills for managing chronic conditions. Advanced communication abilities, behavior change techniques, patient education, and counseling skills are necessary in helping patients with chronic problems (WHO, 2002). Health care personnel with less formal education and trained volunteers have critical roles to play.
Center care on the patient and family	Management of chronic conditions requires lifestyle and daily behavior change. Focusing on the patient in this way constitutes an important shift in current clinical practice. The present scenario has a patient role as a passive recipient of care, missing the opportunity to leverage what he or she can do to promote personal health. Health care for chronic conditions must be re-oriented around the patient and family.
Support patients in their communities	Patients and families need services and support from their communities. Communities can also fill crucial gap in health services that are not provided by organized health care.
Emphasize prevention	Most chronic conditions are preventable. Strategies for reducing onset and complications include early detection, increasing physical activity, reducing tobacco use, and limiting prolonged, unhealthy nutrition (Wielawski, 2011; WHO, 2002). Prevention should be a component of every health care interaction.