EDITORIAL In This Issue: New Concepts for Diabetes and Chronic Disease Management

This issue of Annals brings into view new ways of understanding chronic illness care1 and efforts to improve the quality of care.2-4 It identifi es a possible new diabetes risk factor that is easily visible on physical examination, rather than requiring an expen-sive or invasive test.5,6 Research in this issue shows that the electronic medical record is not a panacea for improving chronic illness care7 and discovers a novel typology of 3 ways that high-performing practices achieve high-quality care.8 Four of these studies take place in practice-based research networks (PBRNs),1,5,7,8 and an additional study characterizes the increasing capacity of PBRNs.9 This research shows that amidst the growing recogni-tion of the potential of PBRNs by outside investigators and by the National Institutes of Health Roadmap,10,11 there is a concomitant need to foster bottom-up par