To discover, identify, and develop best practices for safe and effective health information technology (HIT) design, development, implementation, use, and evaluation.


CIRCLE aims to respond to the loss of the “clinical informatics research laboratory”, where researchers worked closely with their organizations to develop, implement and evaluate their homegrown electronic health record (EHR) systems. A clinical informatics research laboratory must allow iterative testing and refinement to develop best in class ideas and techniques for ensuring safety and effectiveness of the user interface, clinical workflow, and clinical decision support, and address many other EHR challenges that arise.

Over the last 10 years, most homegrown EHRs have been replaced by commercially-developed systems. While this addressed problems related to system maintenance, reliability, and inconsistent annual costs, it has significantly curtailed the ability of informatics researchers at a single organization to experiment with different designs, configurations, and implementation strategies due to tight external control.

To allow EHR-enabled healthcare systems to achieve the transformative powers promised by early EHR pioneers, it is imperative that we learn from natural experiments that are occurring in organizations around the world that are using different EHRs. These organizations make different configuration decisions and use the systems in distinct ways and often make mistakes in the process and learn important lessons. However, currently this learning is not being tapped or disseminated.


To establish a virtual group of individuals who can contribute to clinical informatics research and address data, information, or knowledge needs for safe and effective design, development, implementation, and use of health information technology.


  1. Prioritize research projects and activities for the coming year
    1. Gather research ideas
    2. Convene an in-person annual meeting of members to:
      1. Identify and prioritize research areas
      2. Develop and refine methods for carrying out research projects to address these areas
      3. Improve trust and collaboration among CIRCLE participants
  2. Publish high-quality, peer-reviewed scientific articles describing the findings of our studies and make evidence-based recommendations on the best practices related to these findings.
  3. Disseminate these findings and best practices to both EHR developers and users worldwide.
    1. Disseminate identified best practices
    2. Make policy and practice impact related to these practices


  1. We strive to be an independent, trusted, and respected voice regarding the safe and effective design, development, implementation, use, and evaluation of health information technology.
  2. We agree to share our findings through peer-reviewed publication in the scientific literature and give appropriate credit to everyone involved in the work.
  3. We value the scientific process which focuses on the unbiased collection, analysis, and interpretation of data when available over expert opinion.
  4. We believe that to achieve the vision of providing the highest quality, safest and most effective health information technology-enabled care HIT possible, that developers and HIT users must share responsibility.