The Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) is an ongoing prospective data collection initiative that began in January 1995. The cohort for the initiative is all patients undergoing cardiac catheterization in Alberta. Patients are followed longitudinally for the determination of short and long term clinical, economic and quality of life outcomes. The project is producing valuable information on the processes and outcomes of cardiac care in Alberta, and is now being implemented in British Columbia as well. This paper provides an overview of APPROACH with specific attention to the project's general objectives, salient features, database structure and technical specifications. Examples of applied research projects based on APPROACH data are also provided.