The care and data challenges surface when a patient has 2 more chronic conditions. The management may be spilt between the primary care physician and a specialist such as a nephrologist, cardiologist, pulmonologist, and oncologist. The primary disease or condition may be managed by a specialist but the question -who is managing the comorbidities and where does all this document The CDC reminds us that one in four Americans have multiple chronic conditions and that number rises to three in four Americans that are 65 or older. https://www.cdc.gov/chronicdisease/about/multiple-chronic.htm