The Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) centers at the HMO Research Network Center for Education and Research on Therapeutics (HMORN CERT) and the University of Pennsylvania are developing a design for a scalable distributed research network (DRN) to support a wide array of purposes related to therapeutics, including comparative effectiveness, safety, and utilization, as well as quality of care research. The project will implement a system prototype, conduct a proof of principle research project on hypertension therapy, and make recommendations for future expansion of the network.