Changing delivery-of-care processes for rheumatic diseases to improve outcomes and costs will require redesign not only within rheumatology practices but also within health systems. Preventive services, acute care, management of chronic co-morbidities, and rheumatology care for rheumatic disease patients can only be accomplished through the close integration of multiple practices and other health system resources. Rheumatologists can play an important role in system-level process improvement without which our own patient care will be compromised. Continuous Quality Improvement methods, also known as Plan-Do-Study-Act (PDSA) cycles, are ideally suited for system-level process redesign. This second of two companion articles describes the properties of systems and explores the redesign of interdisciplinary rheumatic disease care.