"We have a very diverse group of [health information exchanges] that started in many different ways but are in some ways evolving in the same direction, which is an interesting trend," said Kate Berry, CEO of the National eHealth Collaborative, during a June 28 HIE Leaders Roundtable webinar hosted by the Washington, D.C.-based organization. NeHC brought together 12 HIE leaders of operational HIEs together to talk about critical success factors for establishing an HIE and sustainability. During the discussion, HIE Leaders highlighted the importance of focusing on end users and making exchange easy for providers and vendors. They emphasized the importance of having core competencies in change management and workflow re-engineering. Tom Fritz, CEO of Inland Northwest Health Services in Spokane, WA said his organization provided collaboration for previously competing health organizations in its market. INHS also partnered with physicians, which was "one of the most important things to determine value to our system." Moving forward, Fritz said he expects more services to be developed including data analytics. "We stay away from transaction fees."