U.S. Regional health information organizations: progress and challenges.

We surveyed regional health information organizations (RHIOs) to assess the state of electronic health information exchange in the United States. We found fifty-five operational RHIOs, and most were focused on exchanging test results. Forty-one percent of operational RHIOs reported receiving sufficient revenue from participating entities to cover operating costs. Of the remainder, only 28 percent expected to ever do so. RHIOs in the planning stage were far more optimistic. Operational RHIOs from our 2007 survey had made little progress in expanding the breadth of their activities. Although the number of operational RHIOs is growing, their scope remains limited and their viability uncertain.