One of those needs is to become a common platform for pushing information to their provider community, which is more efficient than the way it's done today. If you think about what a hospital does today, they're required to send out lab results for the outpatient, and then radiology reports to the provider community. Right now they do it in an inefficient, clunky way. Then you add on top of that the expectations coming from Meaningful Use.

Hospitals are also very often the drivers of these ACOs. As they look to their needs regarding ACOs, they start to need things like care management functions, population health, using medical record information to identify risk, patient engagement — all those things they're seeing as being closer and closer to the core of what they're being asked to do in affordable care, and using HIEs to accomplish that.

DMN: What do you predict for the future of HIEs?
MT:I think we're going to see private HIEs flourishing even more than they are now. We're seeing that already. We're certainly seeing it in New England, as we work, private HIEs are starting to blossom from the bottom up. The second is that the state level HIEs that don't pivot or change their business approach to recognize that reality and then figure out how to provide complementary services are not going to survive. The good news is that the ones that do that will survive and offer a nice complementary service.

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