This white paper chronicles lessons from the California Improvement Network (CIN), whose partner organizations focus on spreading the best ideas in chronic disease care to more California providers.

While there has long been recognition about the importance of sharing better practices across health care organizations, diffusion of these practices has typically been slow. In 2007, CHCF and seven public and private organizations (an eighth joined in 2008) formed the California Improvement Network to help spread better practices that improve care for patients with chronic diseases.

As detailed in this report, CIN members have learned to share better practices and focus on ways to better spread them among providers, teams, clinic sites, and even across patient conditions. Among the results:

• CIN was able to increase the number of providers who engaged in quality improvement (QI) activities and used chronic disease registries (automated systems to track care for specific groups of patients, e.g., those with a diagnosis of diabetes).
• Over two years (2007 to 2009), seven CIN partners increased the number of patients tracked in chronic disease registries and improved the use of registries for reminders and outreach.
• Six partners demonstrated increases in the number of "engaged practices" — that is, clinical practices that use registries, deploy evidence-based guidelines, promote patient self-management, and/or track improvement processes and outcomes.

Although these approaches have been demonstrated to improve chronic disease outcomes, the report finds the most challenging work remains in establishing networks and processes that encourage primary care practices to implement them. 

The complete report is available as a Document Download.