Background: Quality measures (QM) ideally should assess the same criteria at the population level in all countries. The global goal of healthcare organizations is to improve quality at affordable costs. To improve quality, large hospital information systems are today integrated with Decision support (DS) functions at the point of care to improve clinical outcomes and promote evidence-based practice. Evidence-Based Medicine electronic Decision Support (EBMeDS) is a simple and flexible solution for linking context-sensitive evidence and guidance with any electronic health record or data warehouse containing structured data. EBMeDS uses scripts which are small pieces of program code that contain rules and algorithms. The primary source of EBMeDS evidence content are the Cochrane reviews of The Cochrane Collaboration, an international body of expert volunteers who apply a rigorous systematic process to publish reviews of the effects of interventions tested in randomized controlled trials. Objectives: We have initiated collaboration in order to implement a DS authoring solution and implement the DS generated in EBMeDS to run against data in the hospital information system for QM. The authorizing tool developed in Finland will be implemented at Orlando Regional Healthcare with the objectives to: (1) Pilot a web-based tool for defining rules to trigger DS functions in a hospital information system, describing the DS functions in plain language, modelling the logic of clinical decisions, and linking it to relevant evidence. (2) Test the DS for QM at two very different organizations: a US acute care hospital (Orlando Regional Healthcare) and a Finnish community health service (Karstula). Methods: Implementation is described in qualitative and quantitative terms, and the developers, users, and administrators at the participating organizations are interviewed. Results: The results will be presented at the Colloquium. Conclusions: We shall share the experience and impact of global cooperation. The report will include a preliminary assessment of the impact of DS based reminders for care of individual patients as a flexible QM tool.