1. Is the assertion "all health care is local" valid? 2. What are the strengths and weakness of a centralized versus a decentralized approach to health information exchange organization within a state? 3. What are the challenges or advantages for states on the cutting-edge of new policies? 4. Given the history of the HEAL NY program, what would you have changed, when, and why? 5. What factors contributed to the success of the HEAL NY program? 6. What should other states take away from the HEAL NY program? What lessons are applicable to the ongoing effort to develop nationwide HIE