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Interoperability knowledge hub

Get everything you need to know about interoperability in healthcare and what it means for hospitals and providers today.


A health information exchange (HIE) is an EHR system that allows exchange of patient information between organizations in a health care system or community. An HIE can be run by a public group, such as the Office of the National Coordinator (ONC) State HIE Cooperative Agreement Program, or a private organization, such as a hospital system or provider group.

HIEs have been around in one form or another since the 1990s. As of 2012, more than 250 HIEs were in active operation. Most early HIEs were public entities that relied on grants and public funding. Due to these somewhat volatile funding sources, these HIEs have struggled to develop financial sustainability. In the face of this lack of sustainability, private HIEs have increased in number. The private option offers the physician or organization more control of design and implementation of the HIE. However, even private HIEs have struggled with financial sustainability because of high up-front costs and the need for large numbers of participants to be effective. 

What's more, although an HIE can theoretically be an interoperable system, most — public and private — typically do not make the mark. A private HIE developed by an organization to suit their specific needs may not have the health IT interoperability to exchange information outside of the organization that developed it. A public HIE may create a larger network of providers than a private HIE but may still be unable to communicate with providers outside of that network.

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