"ECHO, European Collaboration for Healthcare Optimization, gathers the interests for Healthcare Performance Measurement of different Academic and Research Institutions from six European countries and an International Body for Healthcare Policy Analysis. Designed as a 48 months project, it has been conceived as a “pilot study” based on available administrative databases. It aims at describing the actual performance of six different Healthcare Systems at hospital, healthcare area, regional and country level. To tackle performance measurement in this project, two different methodological approaches will be used: [a] a population geographical-based, responding the question: Is the access to a diagnostic or surgical procedure dependant on the place where a person lives? And, [b] a provider-specific, answering the question: Is the risk for a patient to access high quality care -and have better health outcomes- different regarding the provider in which he or she is admitted? Utilization, equity in access and allocative efficiency will be analysed as performance measures in the former approach; and, healthcare outcomes and associated costs will be measures in the latter one. ECHO has been envisaged as a five work packages project. The first two work packages are devoted to prepare the core work package (WP#3) Performance Measurement and Report; so, the WP#1 is committed with the creation of the ECHO Data Warehouse and the second one is dedicated to the Methodological foundations of the project. Work packages #4 (web-based tools development) and #5 (dissemination) are carefully thought to ease the diffusion of our findings to decision-makers; in the former, a web-based analytical tool will allow advanced users to replicate methods and analysis; in the latter, local key agents like policy decision-makers and managers, will feed the findings making them transferable to their own decision-making process."