Chronic Disease Management

We support people with chronic disease by:

  • Promoting self management
  • Improving coordination of care
  • Supporting evidence based management and prevention
  • Supporting the use of Telemedicine in chronic disease

Our overall goal is to decrease the reliance people with a chronic disease have on hospital staff and other health professionals.

Obesity Management Service

The Obesity Management Service supports adults with a high level of obesity to improve their health and wellbeing. The Service focuses on those who are at high risk of developing complications from their obesity or those who already have additional health problems. The Service team includes doctors, nurses, dietitians, psychologists, physiotherapists and exercise physiologists.

Download: OMS Service Model (PDF File - 675k)
OMS Information for Patients (PDF File - 128k)
OMS Information for Clinicians (PDF File - 251k)

Chronic Disease Management Symposium 2013

Consumers, students, researchers and health professionals were invited to the Chronic Disease Management Symposium 2013 with the theme of 'Implementing the Chronic Conditions Strategy for People with Multi-Morbidity'.

Date: Monday 2nd December 2013
Time: 12:00pm - 5:00pm
Venue: ANU Medical School Auditorium, Building 4 at Canberra Hospital

Download: 2013 CDM Symposium Summary (PDF File - 428k)
2013 CDM Symposium Program (PDF File - 1053k)
2013 CDM Symposium Flyer (PDF File - 438k)

About the Chronic Disease Management Unit

The Chronic Disease Management Unit is a multidisciplinary team that supports service development in this rapidly changing field.

Our focus is on improving the management of ACT residents with Diabetes type 2, Chronic Lung Disease and Chronic Heart Failure through supporting evidence based practice, secondary prevention (prevention of complications and improvement of quality of life for people who already have established disease) and consulting with other units on health service design.


Health professionals can refer patients to our Chronic Disease Management Services through Community Health Intake

Our approach

Our approach includes a range of interventions such as:

  • Improving case management and coordination
  • Clinician feedback
  • Clinical information systems to track patient care
  • Promoting patientís self management skills

Policies and Plans

Visit the Policies and Plans section of this website, for a full listing of ACT Health's policies and procedures.