A lack of interoperability impairs data quality among health care providers' electronic health record (EHR) systems. The problem is whether the International Organization for Standardization (ISO) 9000 principles relate to the problem of interoperability in implementation of EHR systems. The purpose of the nonexperimental quantitative research study was to examine the relationship between universal quality management standards (ISO 9000) and EHR interoperability in the United States. Electronic health record systems are a pivotal aspect in the establishment of the Nationwide Health Information Network. If a relationship exists between ISO 9000 quality management principles and EHR system interoperability, then the quality management principles would be consistent with Almgren's social justice theory that all citizens have a right to quality health care because EHR interoperability is seen as necessary for the improvement of health care. The research included a nonexperimental quantitative design to ascertain a relationship between perceived level of EHR interoperability and universal quality management principles. A survey instrument was administered to 399 health care professionals who were members of the American Medical Informatics Association, the Pennsylvania State Nurses Association, and the Association of Women's Health, Obstetric and Neonatal Nurses. Factor analysis, correlation analysis, and multiple regression analysis were performed on the data gathered by the survey instrument. Factor analysis did not indicate the existence of eight separate factors, but rather one factor. The one factor discovered in factor analysis was quality management. A correlation and simple regression were performed between perceived interoperability level and the quality management factor. A significant positive correlation [r(292) = 0.301, p < 0.000] existed between the perception of EHR interoperability and the quality management factor. The simple regression had an R-squared of 0.091, which indicated that while the relationship exists between perceived interoperability level and quality management, the amount of variance in the outcome variable explained by the predictor is not large. Recommendations for further research in the field include further investigation into the ISO 9000 quality management standard, other universal quality management standards, and the effect of organizational cultural health care information technology implementation. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]