Dr. Ed Wagner and the Improving Chronic Illness Care (ICIC), described that the aim of the Chronic Care
Model was to improve patient health outcomes by changing the routine delivery of ambulatory care for patients
with chronic illnesses from acute and reactive to proactive, planned, and population-based [2]. Morehouse Family
Medicine Residency Program received a Health Resources and Services Administration (HRSA) residency
training grant to develop a Chronic Care Model curriculum with a focus on diabetes [2] [3]. One of the goals
was to develop a diabetes registry to improve clinical outcomes. We discovered several flaws in the data with
the implementation of the diabetes registry.
Previous studies utilizing health information technology showed improvement in diabetes outcomes [4] [5].
The aim of this paper is to demonstrate improved process and quality outcomes for patients with diabetes by
redesigning our healthcare delivery system with data feedback.