Figure.

Key steps in the partnership to establish and maintain diabetes care registries between state diabetes programs and primary care practices, Montana and Wyoming, 2004.

	State Diabetes Programs (Nurses and Other Staff):	Physician Office (Physicians, Nurses, and Other Staff):	Primary Focus:
Installation of Registry	Supply software (no cost to the practice) Identify patients with diabetes (using billing data for initial selection) Abstract data from medical records Enter data into practice-based computer Train practice staff	Supply computer and printer Provide access to billing data and medical records Confirm interest in using computer-based registry	Prepare for quality-improvement activity
Office Use for Patient Care	Maintain regular telephone contact with practice staff Conduct regular on-site visits to review and support use of software by practice staff Review Population Practice Profile to help identify population-based opportunities to improve care Identify need for and arrange continuing education for clinicians	Review and update patient profile at each patient visit Recognize services due or undesirable metabolic values Take appropriate clinical action	Improve care one patient at a time
Special Quality Improvement Projects	Publish Quality Improvement Report on a quarterly basis Aggregate and analyze data from quarterly summary report Assist with design and evaluation of quality-improvement projects	Identify and select quality-improvement topic(s) Implement quality-improvement projects Recognize special efforts of practice staff members	Improve care for the population of patients (sometimes for selected subgroups of the population)