Feeding information from electronic health records to health information exchanges ought to be easy, but so far it's been plagued by the same kinds of costs and technological obstacles as any other effort to interface one piece of HIT to another.

"There are lots of HIE standards out there, but they're not being consistently implemented," says Anuj Desai, director of business development for the New York eHealth Collaborative, which oversees HIT for New York State. "Some vendors are trying to charge physicians $150,000 to get their EHRs connected to a health information exchange."

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