This project is designed to test the effectiveness and cost-effectiveness of a multi-faceted and largely self-directed organizational change intervention for implementation and use of diabetes registry in primary care practice. Participating practices will use a diabetes care registry to target evidence-based processes of care with the goal of improving patient attainment of recommended outcomes of care targets for HbA1c, blood pressure control and lipid control. Following recruitment and randomization of 30 primary care practices into intervention and control arms, clinician champions will be identified by practice leaders and attend a series of three meetings over the course of the intervention. At these meetings, champions will receive brief instruction in population health concepts, effective team leadership, organizational self-assessment, work process redesign and use of a computerized registry system. In addition, champions will share successes and challenges faced in the implementation process to encourage sharing successful techniques. At each participating practice, the clinician champion will be responsible for the intervention and will lead a process of organizational self-assessment and work process redesign to support implementation and use of a diabetes care registry. During the eleven-month implementation and initial registry use period an outside Peer Mentor will make quarterly visits to each practice and schedule monthly phone consultations with local clinician champions. During their visits, the Peer Mentors will meet with practice champions and advise them on methods for overcoming implementation barriers related to work process redesign. Peer Mentors will consult with a work process redesign expert as needed. For technical or computer-based barriers the Peer Mentor will coordinate access to a technical support staff member of the project.