State and community-based efforts to foster interoperability.

The MidSouth eHealth Alliance is developing a comprehensive health information infrastructure supporting providers in three Tennessee counties. Success in the alliance's first year is the result of sustained leadership, a systematic assessment of regional needs and capabilities, a flexible technical architecture, and a critical review of best practices from four different data exchange models already operating in other states. Long-term evolution to a truly interoperable health information infrastructure will depend on the extent to which the alliance demonstrates value to consumers and practitioners.