The 1997 Legislature, in Senate Substitute Bill 5445, instructed the Department of Health to conduct a study to determine the feasibility of collecting and reporting data about ambulatory arid outpatient health care encounters in Washington. The vast majority of health care delivery occurs in ambulatory and outpatient settings, and the trend in Washington over the past decade is for an increasing number of services to shift to these settings. Despite the large volume of data generated about the care delivered in ambulatory and outpatient settings, however, there is no central source to access these data, nor are data elements comparable across providers. In addition, the fragmented databases that do exist are proprietary to those who have collected the data and are rarely available for research or other public uses.