The clinical scenario is familiar to many doctors, according to Dr. Paul Abramson, board member of the San Francisco Health Information Exchange: An elderly man, unconscious and seriously ill, arrives in the ED by ambulance. No friends or relatives are available, and the man has never visited this emergency department before. The treating doctors must start from scratch to diagnose and treat this patient, with no knowledge of his other physicians, past medical history, medications or previous medical care. The concept of HIE ultimately aims to make the story play out differently: The same man arrives at the hospital by ambulance. The paramedics locate his name and birth date from a driver's license and the ED triage staff enters this into their computer. After a local search fails to find a record at that hospital, the computer automatically sends a request to the local HIE, which authenticates the query then polls its network of data sources, returning lab results, a recent hospital discharge summary and discharge medication list from another hospital, echocardiogram and stress test reports from the cardiologist and recent progress note from the patient's primary-care doctor, including a current problem list, allergies and medication list. Hospital Impact