Managing complexity in chronic care: An overview of the VA state-of-the-art (SOTA) conference

INTRODUCTION: The aging of the population and the increasing prevalence of multiple chronic illnesses, along with multiplying options for clinical management, pose great challenges to both the Veterans Health Administration (VHA) and the broader US health care system. Developing effective and efficient health care for persons with complex and multiple medical conditions is a national priority. Therefore, research in this area is critically important. In 2006, the VHA Health Services Research and Development Service held a state-of-theArt (SOTA) conference titled "Managing Complexity in Chronic Care" to clarify our current understanding of the management of complex chronic conditions and suggest directions for research to better address this important problem. OBJECTIVE: This article provides an overview of the major findings from that conference, including major presentations, summaries of the workgroup deliberations, and a list of research topics that were thought to be of highest importance to advancing our ability to provide medical care for persons with complex chronic care needs.