What innovative strategies could fill the gaps?

In addition to the increase of self-management support development and implementation activities, several innovative initiatives are taking place with promising potential. In the United Kingdom, the Chronic Disease Self-Management Program (known as the Expert Patients Programme) is being delivered by the Expert Patients Programme Community Interest Company (EPP CIC), a not-for-profit social enterprise set up to meet a public need and to reinvest profits for the public good. The EPP CIC was established in 2007 to expand the work already undertaken across England in the area of self-care and self-management. The purpose is to establish the principle of individual self-management and self-care as a recognized public health measure, deliverable in a cost effective and sustained way, increasing the number of courses from 12,000 a year to over 100,000 by 2012. The name of the initiative derives from the belief that expert patients should be considered not only as health providers, but also as important contributors in the collective intelligence that must be developed if multiple chronic diseases are to be managed successfully (http://www.globalalliancesms.org/about-g...). 

Group Health Cooperative, an American consumer-governed nonprofit health care system that coordinates care and coverage, is implementing new technology to facilitate remote participation in self-management.

The rapid penetration of the Internet and Web 2.0 resources, along with the convergence of mobile ‘smart’ telecommunication devices and social networking tools, there is an unprecedented opportunity to foster global interventions to promote sharing and adoption of successful experiences worldwide.  The emergence of “one-to-many”, “many-to-one” and "many-to-many" communication tools such as Facebook (http://www.facebook.com), Twitter (http://twitter.com) and Google Wave (http://ww.wave.google.com) is opening new frontiers to self-management (92).

Online social networking technology is being applied directly to promote self-management and optimal levels of patient education. Organizations such as PatientsLikeMe (www.patientslikeme.com), MD Junction (www.mdjunction.com), WellSphere (www.wellsphere.com), WebMD (www.webmd.com), the Association of Cancer Online Resources, Inc. (www.acor.org) (93, 94), New Health Partnerships (www.newhealthpartnerships.org), e-Patients (www.e-patients.net) or the Society for Participatory Medicine, among many others, are creating unique opportunities for networked patients and their loved ones to become the main drivers of their health-related decisions (http://participatorymedicine.org/). Those responsible for health policy, patients' associations and caregivers have now  tools of immense power to engage in true partnership with patients to make self-management support and education a global reality.