The Santa Barbara County Care Data Exchange: What Happened?

The Santa Barbara County Care Data Exchange was once one of the most ambitious and publicized U.S. health information exchange (HIE) efforts. Eight years after its inception, and several months after providing some data, the Santa Barbara Project shut down operations. Despite its developed HIE infrastructure, participants found no compelling value proposition in initial HIE services. Although there are several proximate causes for the project's slow progress - California HealthCare Foundation (CHCF) grant money, lack of community leadership, vendor limitations, and the duration of the process - the main underlying cause was lack of a compelling value proposition for Santa Barbara organizations.  Even with fewer technology delays and more community leadership, other regional health information organizations (RHIOs) may also stumble over HIE service-value propositions without some combination of grants, incentives, and mandates that develop initial RHIO infrastructure and services and ensure provision of unprofitable yet socially valuable services.