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Our funding for updating this website ended in 2011, but the resources we developed are still helping clinical practices from around the world to transform the care they provide to better serve patients with chronic illness. Please visit our home page to learn more—or check out our more recent tools and resources at:



  1. McDonald KM, Sundaram V, Bravata DM, et al. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 7—Care Coordination. Rockville, MD: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services; June 2007. [link]

  2. Cummins RO, Smith RW, Inui TS. Communication failure in primary care. Failure of consultants to provide follow-up information. JAMA. Apr 25 1980;243(16):1650-1652. [link]

  3. Gandhi TK, Sittig DF, Franklin M, Sussman AJ, Fairchild DG, Bates DW. Communication breakdown in the outpatient referral process. J Gen Intern Med. Sep 2000;15(9):626-631. [link]

  4. Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. Feb 28 2007;297(8):831-841. [link]

  5. O'Malley AS, Tynan A, Cohen GR, Kemper N, Davis MM. Coordination of care by primary care practices: strategies, lessons and implications. Res Briefs. Apr 2009(12):1-16. [link]

  6. Antonelli RC, McAllister JW, Popp J. Making Care Coordination a Critical Component of the Pediatric Health System: A Multidisciplinary Framework The Commonwealth Fund; May 2009. [link]

  7. McAllister JW, Presler E, Turchi RM, Antonelli RC. Achieving effective care coordination in the medical home. Pediatr Ann. Sep 2009;38(9):491-497. [link]

  8. Pham HH, O'Malley AS, Bach PB, Saiontz-Martinez C, Schrag D. Primary care physicians' links to other physicians through Medicare patients: the scope of care coordination. Ann Intern Med. Feb 17 2009;150(4):236-242. [link]

  9. Committee on Quality of Health Care in America,  Institute of Medicine, "Crossing The Quality Chasm: A new Health System for the 21st Century", Washington DC: National Academy Press; (2001).  [link]