Health information exchanges have yet to become the darlings of most hospitals and medical practices, but despite their frostly reception, two recent studies suggest you can launch and maintain a viable HIE.

These health data sharing organizations will undoubtedly play an important role as the HITECH Act's Meaningful Use programs continue to take shape. So it's time to take a closer look at lessons learned from such success stories.

A new report released this week by the National eHealth Collaborative (NeCH), a public-private cooperative funded by the Office of National Coordinator for Health IT, outlined some of the" secrets" uncovered by 12 successful HIEs.

Many HIEs can learn from these lessons--especially considering that there are at least 255 HIEs in the U.S. right now, a 9% increase from 234 HIEs last year, and up significantly from only a few dozen in 2004, according to the eHealth Initiative, another coalition that studies HIEs and which recently completed its own annual report.

For those of us that have been following HIEs over the last decade or so, it's been pretty clear that success--and sustainability--has been elusive for many of these organizations. There have been failures along the way, most notably the once promising Santa Barbara County Care Data Exchange in California, which launched in 1999 and lasted only a few difficult years before shutting down in 2006.

I would argue that the Santa Barbara effort was a visionary for its time--and that proved to be one of its biggest problems. Unfortunately their effort was launched several years before the HITECH Act was signed into law--meaning before EHRs appeared on the radar screens of large numbers of healthcare providers in the region. When the Santa Barbara exchange launched, few healthcare providers were open to the idea of using and sharing digitized patient data--especially among competing doctors and hospitals.

Of course, most of the 12 successful HIEs studied by NeHC in its "Secrets of HIE Success Revealed, Lessons from The Leaders" report have also been around for quite some time, launching pre-HITECH Act, but none as early as the Santa Barbara effort.

Although most of them have no doubt struggled with their own stumbling blocks--big and small--they've been able to recover. That's evident from the "secrets" revealed by the National eHealth Collaboratives report.

Here are some of keys to success among top HIEs:

1 -- An HIE needs to make sure stakeholders see the value of participating in the HIE--and then make sure they deliver on those promised services. That value includes reduced data distribution costs and increased staff productivity, which are "the major reasons why participants are willing to pay for the services offered by these HIEs," according to the NeHC report.

2 -- HIEs must collaborate and align with stakeholders about their priorities for the group. Because stakeholders of an HIE are diverse--they can include payers, competing hospitals, doctor groups and solo practices--their needs differ. So, successful HIEs need to engage the stakeholders in coming up with "win-win" collaborations.