1. Chronic Disease Tracking System  Problem  The current healthcare model focuses on one patient at a time in the office.  Chronic disease leads to higher morbidity/mortality than does acute disease.  What we know  Evidence-based care applied consistently and proactively improves outcomes for patients with chronic disease.  Proposal  Implement an electronic registry Tracks interventions and clinical parameters for chronic disease Alerts providers when there are problems

2. The data is already available…

3. Impact…  Community  Patients  Clinicians  Students  Research