The goal of this project was to create and evaluate a quality measures program for colonoscopy procedures using measures recently defined by multi-specialty groups and using resources of the Clinical Outcomes Research Initiative (CORI), a gastrointestinal endoscopy research consortium. Participants collect procedure data through an endoscopic reporting system developed by CORI. Endoscopists practicing at 35 sites in 21 communities and 16 states were included in the study. Individual quality reports with 15 measures were made available monthly to endoscopists in 2/3 of the communities. Compliance with the quality measures was captured for each endoscopist prior to and at the end of the one-year intervention period. Changes in measure compliance were small and limited by lack of pathology data and documentation as well as modifications to the computing system during the study period. This study points out the difficulties of utilizing quality report cards with data captured during clinical care.