Health Information Exchanges Objectives Timely access to patient information Improved quality of care Reduce costs of care Challenges EMR/EHR interoperability, Adoption and usage by physicians and practices Network externalities and patient flows Topographies of patients and physicians networks Institutional isomorphism Impact on costs and quality of care Avoidance of procedural repetitions Better use of timely information Patients’ privacy concerns Drivers and inhibitors of patients’ concerns HIE and Medical Referrals – referring wisely and effectively HIE Participation and Physicians’ Referral Patterns: Are they Mutually Reinforcing? To what extent non-medical factors affect referral choices? How to optimize referral decisions to minimize the cost and maximize the quality of care? How to enable and encourage physicians to adopt optimized referral models?