PROJECT SUMMARY Cognitive impairment, physical disability and progressive disease are common but understudied clinical outcomes that substantially impact employment and overall quality of life for individuals with multiple sclerosis (MS). We have recently developed and validated an assisted, web-based tool (ICLIC-MS) for systematic and longitudinal clinical outcomes data collection of MS-validated cognitive function measures, physical disability and progressive disease measures that are not reliably captured in the electronic health record (EHR). In response to FOA# PA-17-010, Use of Technology to Enhance Patient Outcomes and Prevent Illness, our team proposes the study of MS outcomes in a large, multi-ethnic population representative sample of more than 3,000 female and male MS cases from the Kaiser Permanente Northern California Health Plan Membership. We will integrate other EHR data such as important comorbid conditions, use of disease modifying therapy, MRI reports, as well as quality of life measures and employment histories. Our goals include: 1) comprehensively characterizing clinical outcomes in a large MS patient cohort; 2) developing and utilizing an integrated MS health report to enhance patient care; and 3) establishing a resource for clinical outcomes research in MS that also includes whole genomic and environmental exposure data. Findings from our proposed study represent an extraordinary opportunity to facilitate effective long-term management of MS, accelerate progress in the understanding of disease pathogenesis, predict patient trajectories and inform prevention strategies. We have assembled a team with strong expertise in clinical neurology/MS neurology, advanced epidemiologic methods, EHR structure and clinical care within a health maintenance organization, human genomics, biostatistics, and big data approaches.