Chronic Disease Registries

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Management of chronic diseases like diabetes, heart failure, and asthma is changing the practice and scope of primary care medicine. With the advent of PQRI initiatives that provide financial incentives to health professionals who measure and report their adherence to quality of care standards, disease registries are starting to realize an even greater role in primary care practices – insuring compliance and providing reports to obtain the incentives.


A computerized disease registry is a system that is used to track the important features of various chronic diseases. These are usually supplemental systems to the individual patient medical records, and are used to support the health professional by:

  1. Identifying patients with a given condition, and providing a simple way to track their progress, studies, and treatments, to insure follow-up, and to identify high-risk patients that have gaps in their care
  2. Insuring timely and appropriate care is administered through clinical reminders and audits, with the use of clinical evidence-based guidelines to drive care
  3. Providing a rich source of information and patient lists that can be queried to help improve the care process and systematically measure improve patient outcomes

Diseases registries are generally disease-specific, and can therefore have highly specific user interfaces, data fields, reports, and decision support built in. In addition, they can be used completely independently of an EHR, which makes them cost-effective for the vast majority of primary care practices who have not yet implemented this more comprehensive technology. Additionally, many registries can be integrated to work within the framework of an EHR, when the practice does eventually adopt one.


  1. Schmittdiel J, Bodenheimer T, Solomon NA, Gillies RR, Shortell SM. Brief report: The prevalence and use of chronic disease registries in physician organizations. A national survey. J Gen Intern Med. 2005;20(9):855-8.
  2. Using Computerized Registries in Chronic Disease Care. Available at: [Accessed February 27, 2009].

Submitted by Maulin Shah