Background The use of clinical databases improves quality of care, reduces operating costs, helps secure managed care contracts, and assists in clinical research. Because of the large physician input required to maintain these systems, private institutions have often found them difficult to implement. At LDS Hospital in Salt Lake City, Utah, we developed a cardiovascular information system (LDS-CIS) patterned after the Duke University Cardiovascular Database and designed for ease of use in a private hospital setting. Methods Features of the LDS-CIS include concise single-page report forms, a relational database engine that is easily queried, automatic generation of final procedure reports, and merging of all data with the hospital’s existing information system. So far, data from more than 14,000 patients have been entered. Results LDS-CIS provides access to data for research to improve patient care. For example, by using data generated by LDS-CIS, the policy requiring surgical backup during percutaneous transluminal coronary angioplasty was eliminated, resulting in no increased patient risk while saving nearly $1 million in 1 year. LDS-CIS generates physician feedback reports documenting performance compared with peers. This physician self-evaluation has standardized and improved care. Information from LDS-CIS has been instrumental in securing and maintaining managed care contracts. LDS-CIS risk analysis provides physicians with outcomes data specific to their current patient’s demographics and level of disease to assist in point of care decisions. Conclusion The use of LDS-CIS in the routine operations of LDS Hospital heart services has been found to be feasible, beneficial, and cost-effective. (Am Heart J 1998;136:792-803.)