Health information technology (HIT) will play an important role in most efforts to improve the quality of pediatric medicine, as evident from the range of investigations and projects discussed in this volume. Clement McDonald identified the importance of using information technology as an integral component of quality initiatives early in the development of electronic medical records (EMR). The role of HIT in quality improvement is not limited to tools integrated into EMR, but that remains an important strategy. Today, much attention is focused on interoperability of clinical systems that integrate and share data from multiple sources. There are also additional freestanding quality-improvement tools that can be used without an EMR. This article explores the many roles of HIT in quality improvement from several perspectives.