Connected care - closing the gaps and filling the cracks in health care -- Integrated delivery systems : the connected care ideal -- Care transitions : fractured or flowing? -- Leading for connected care - the senior management role -- Middle managers and connected care -- Care coordination and communication on the front lines - the clinician role -- Experiencing connected care - the patient role -- Pulling together for the patient : teamwork in healthcare -- Digital connections, communication and collaboration -- High risk gaps and cracks I- social determinants of health, health disparities and mental health -- High risk gaps and cracks II- caregivers, dementia and end of life care.