The overall goal of this project is to enable meaningful measurement of the quality of care, with a focus on public health priority issues, disadvantaged populations, and small office practices. The New York City Department of Health and Mental Hygiene's Primary Care Information Project seeks to use health information technology for population-wide measurement and improvement of clinical care in these domains, particularly among disadvantaged populations. As part of this 3-year, $30 million Mayoral initiative, over 1,000 medical providers will be receiving electronic health records (EHRs) with enhanced preventive care functionalities. Ambulatory EHR products will include Epic(tm), Nextgen(tm), GE Centricity(tm), and eClinicalWorks(tm). Clinical partners include all of New York City's federally qualified health centers, several hospital outpatient departments, and hundreds of primary care providers in small office settings, including a subset of practices assembled through the Doctor's Office Quality-Information Technology (DOQ-IT) project. All practices have committed to participating in a citywide quality reporting initiative with a standard set of automated EHR-enabled clinical quality measures that address public health priority issues. A set of candidate clinical quality measures designed to address priority public health issues has been developed, and automated reporting of these measures has been established from the Institute for Urban Family Health, a federally qualified community health center network with a comprehensive EHR implementation. The indicators validated as part of this project will be used in a citywide quality [unreadable] reporting initiative. Successful EHR-enabled quality measurement requires that physicians document relevant information at the point of care. In order to reduce the burden associated with data collection and empower physicians in attaining quality targets, this project will design and test a simple and intuitive "quality dashboard" suitable for small office practices that will integrate quality measurement and clinical decision support at the point of care. The dashboard will show medical providers which measurement cohorts the patient belongs to and whether their care complies with screening and treatment recommendations, while the integrated decision support tools will enable providers to take appropriate action to bring the measure into compliance, or remove the patient from the measurement cohort due to valid exclusions or contraindications. [unreadable] [unreadable] [unreadable] [unreadable]