Health informatic technology has been implemented at an accelerated pace since the adoption of the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009. The first wave of technology was the electronic health records which have a strong presence in many healthcare facilities. The second wave of technology is the health information exchanges (HIE) which will allow healthcare facilities to share patient data to improve coordinated care and reduce costs of duplicated tests. HIEs are not a novel idea, they have been around for the past few decades. However, there has been significant difficulties to addressing privacy and security measures and creating a sustainable economic model. The state of Jefferson has recently implemented an HIE that is being used by a small variety of healthcare facilities. The Jefferson HIE is taking a fairly new approach by allowing the HIE to be lead by the physicians and the community. This research was done through a meta analysis of case studies on HIEs and several interviews with HIE professionals.