With many states instituting their own individual health care reform packages, soon every state will have a Health Information Exchange. The results of the 5th annual Survey of Health Information Exchanges shows that 18 new HIEs have been initiated since 2007, along with 42 Healthcare Information Exchanges that are in an advance state of development. The focus is now becoming what it takes to have continued success and growth of the HIE.

The successful HIEs are sharing richer data, with 26 of the exchanges sharing lab results which are up from 19 in 2007. Currently 23 exchange in depth patient data, again up 2007. The sharing of patient data is a crucial element to the success of a Health Information Exchange. One obstacle to success with the HIEs is the reluctance some providers feel about sharing information.  This is in part, because the providers view the data as a crucial asset, something that allows them to retain their competitive edge and they do not wish to divulge that to another provider.

Another roadblock to total success of the HIEs is that many HIEs can find that being sustainable after the initial government funding ends is very difficult. The HIEs must then rely solely on private funds, many of which are provided by the same providers that are afraid of losing their competitive edge by sharing data. This leads to HIEs that are not willing to share as much information, which slows growth. 

Although it is not impossible to find examples of successful HIEs, for instance, HealthBridge and Indiana HIE the hospitals have agreed to collaborate in a Health Information Exchange, they share crucial data a reason that this exchange is viewed as being extremely successful.

A way to ensure success is the have a state form the HIE, as happened in Minnesota. Their new HIE, which will be the largest in the nation, is state backed. Minnesota collaborated with BlueCross Blue Shield, Allina and Health Partners to form the exchange, which will serve an estimated 3 million consumers. This exchange will be run as a non-profit funded by the organizations involved, providers will pay a subscription fee to be part of the HIE.  The goal is for the providers to exchange medical history, labs, do eprescribing and exchange digital images.