we adopted the Electronic Health Records (EHR). All
staff, faculty and residents were trained to use the EHR. All paper charts were removed from the practice after
one year of the EHR implementation. On July 1, 2007, with additional HRSA funding, we developed and began
the implementation of the chronic care model (CCM) with an initial focus on Diabetes. In collaboration with
PPRNet (Primary (Care) Practices Research network), and Recombinant Data, Inc., a data warehousing company
specializing in the secondary use of clinical data, we set out to create a diabetes patient registry; practice and
individual practitioner reports to identify opportunities for intervention in diabetic care and measure progress on
a variety of quality metrics from the National Committee for Quality Assurance (NCQA) Diabetes Physician
Recognition Program (DPRP) [6].