The provider participates both within an internal institutional framework and an external system aimed at quality improvement. The provider has a quality task force and task force on the future of gastroenterology training. Externally, the provider is represented in various organizations and coalitions where quality issues are discussed and performance measures developed, including the American Board of Internal Medicine (ABIM), the American Medical Association (AMA), the American College of Physicians (ACP), and the National Quality Forum (NQF). Data and insights from these external efforts were integrated into various educational activities. The provider has been actively engaged with the Centers for Medicare and Medicaid Services' Physician Quality Reporting Initiative, along with an NQF workgroup in the development of peer reviewed quality measures. Once measures are adopted, the provider educates its membership and provides tools for integration into practice.