Chronic disease management systems (CDMS), or disease registries, are electronic tools that can help clinicians to better deliver the right care at the right time. Less expensive and complex than electronic health records (EHRs), they can be used to track multiple chronic conditions and often are a stepping stone toward other, more comprehensive, technology systems.
In June 2008, six philanthropies launched "Tools for Quality," a $4.5-million initiative to help community clinics and health centers adopt this technology. The funders were the California HealthCare Foundation, the Blue Shield of California Foundation, The California Endowment, The Community Clinics Initiative (Tides/TCE), and Kaiser Permanente (Southern and Northern California regions).
Tools for Quality, which concluded in March 2011, featured four components:
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Matching grants. Two funding rounds were designated for clinics and clinic consortia (networks of clinics) to purchase and integrate CDMS. A total of 20 grantees representing 36 clinics were chosen.
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Regional training. Three clinic consortia were awarded funding to host learning sessions, where outside experts and peers with experience implementing CDMS shared their knowledge. Curricula focused on introductory quality improvement skills, workflow redesign, registry optimization, patient outreach, population management, physician reporting, and data validation.
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Financial incentives. Grantees received incentives for reporting on standardized clinical measures from automated systems (eligible clinics included those who purchased a CDMS outside the initiative).
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Independent evaluation. A two-year independent evaluation, conducted by NORC at the University of Chicago, assessed community clinics' experiences implementing CDMS and the extent to which these experiences prepared them for future acquisition and use of clinical health IT, especially EHRs.
The final evaluation and an executive summary are available as Document Downloads.