The prevalence of diabetes mellitus, which affects 30.3 million adults in the United States, is increasing with 1.5 million newly diagnosed cases of diabetes each year. An additional 84 million adults are affected by prediabetes. Consequently, this chronic disease has become the seventh leading cause of death in our nation.1 Statistics like these have caused the Centers for Medicare & Medicaid Services (CMS) and state health departments to encourage primary care physicians to not only adopt electronic health records (EHRs) but to use them more effectively to improve management of diabetes and other chronic diseases. This paper discusses how small physician practices in North Texas improved their tracking of quality metrics for hypertension, obesity, and diabetes by leveraging available but underused EHR functionalities. We also describe five "best practices" for more effective use of ambulatory EHRs to manage chronic disease based on findings in this study.