Arkansas is rapidly becoming a leader in health information exchange. Since launching their statewide secure messaging tool (SHARE) in January 2012, Arkansas’s Office of Health Information Technology (OHIT) has registered more than 2,100 clinical and administrative staff to use it, with another 3,000 in queue to be fully on-boarded. SHARE uses the national standard for secure health information transport developed by ONC’s Direct Project. For a rural state that started their State HIE Cooperative Agreement with no existing exchange infrastructure and limited electronic health record (EHR) adoption,

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