A centerpiece of the nation's healthcare information technology vision is the implementation of health information exchanges (HIEs). HIEs have the significant potential to improve the quality of patient care, reduce care costs, and enhance patient safety. These kinds of exchanges are new to healthcare in the United States. While more than 200 communities are in various stages of implementing them, there is little mature experience with the factors that contribute to the successful formation and sustainability of these exchanges. The creation and management of mechanisms to support the exchange of data between organizations has been used in other industries. There are many examples of interorganizational systems that have been established in industries as diverse as banking, manufacturing, government, and retail. This paper examines some of these experiences and attempts to glean the concepts and guidance healthcare can learn from other industries.