In the articles that follow in this Special Report supplement to The American Journal of Managed Care, the reader will note that various types of outcomes--humanistic and economic, as well as clinical--are measured to achieve a balanced picture of the comprehensive impact of the healthcare interventions implemented. Clinical research has only recently evolved to a state in which a balanced-systems approach to outcomes measurement is moving to the forefront. It is therefore important to understand the historical context of the outcomes movement within which the multidimensional approach developed. A description of this historical context is provided below, followed by an overview of the ECHO (Economic, Clinical, and Humanistic Outcomes) Model and case examples of the balance-of-outcomes model as implemented in a large integrated delivery system.