In the U.S. today, more than 5,000 hospices provide care for more than 1.5 million patients every year. These patients receive care in their own homes, in nursing homes, in hospitals, and in dedicated hospice units. In order to provide high quality care that is competent, patient- and family- centered, coordinated, and compassionate, hospices need an evidence base of comparative effectiveness research (CER). However, it is unlikely that CER data will come primarily from randomized controlled trials. These trials are very difficult in the hospice setting because the majority of hospice patients are unable to participate. Moreover, patients enroll in hospice very late in the course of illness, making clinicl trials very difficult. Therefore, in order to advance the science of CER for hospice care in other ways, the research team has developed an innovative CER hospice network (CHOICE: Coalition of Hospices Organized to Investigate Comparative Effectiveness). The overarching goal of the proposed project to investigate the feasibility and validity of EHR-derived hospice data, and to establish the value of the CHOICE network in answering key hospice-focused CER questions. PUBLIC HEALTH RELEVANCE: In the U.S. today, more than 5,000 hospices provide care for more than 1.5 million patients every year. In order to provide high quality care that is competent, patient- and family-centered, coordinated, and compassionate, hospices need an evidence base of comparative effectiveness research (CER). The goal of this project is to demonstrate the feasibility of using an electronic health record-based network (CHOICE: Coalition of Hospices Organized to Investigate Comparative Effectiveness) to advance the evidence base of hospice care.