Practice champion meetings The intervention will begin with a half-day training meeting for representatives from each of the 15 intervention practices who will then serve as "champions" for the intervention in their organizations. Prior to this stage, practice champions will be selected by practice leaders from among the clinicians in their practice using the following criteria: the clinician 1) has their principal employment in the practice, 2) is authorized to lead a practice improvement process and 3) regularly provides care to patients with diabetes. Practices may send more than one practice member to the training session (for example, a member of the nursing or clinical support staff could also attend the meeting). However, one clinician champion will be identified for each practice to ensure the maintenance of the relatively low cost of the intervention. In addition, practice managers will be provided with a detailed description of the intervention so that they can assist the champion in managing needed work process changes. Our experience in the pilot study suggests that a half-day session delivered in the evening is acceptable to primary care clinicians and is sufficient for delivery of the proposed training content. This meeting will be used to introduce practice champions to 1) the objectives of the project (including the focus on using the registry to target evidence-based processes of care improvements59 and cost-effective preventive care60), 2) population health concepts and how these relate to diabetes care in primary care practices, 3) principles of effective team leadership, 4) principles of patient registry construction and use, 5) an introduction to a free stand-alone registry software solution, 6) an organizational self-assessment process that focuses on planning work process changes related to using a registry in their practice, and 7) instruction in the use of study materials to coordinate changes in practice work processes with practice managers. Follow up meetings will be held at three and six months after the initial meeting of practice champions to assess progress with registry implementation, reinforce the learning from the initial meeting, and to share successes and challenges faced in the implementation process. The goal is that champions foster cross-practice learning by sharing successful techniques with each other. Peer Mentors will also attend these meetings.