ABSTRACT
The national health information exchange (HIE) network in Israel is perhaps the world's best kept HIE secret. Few Israelis even know the network exists, yet this HIE network has broad adoption across Israel's health system, and it has facilitated many landmark studies on HIE in the biomedical literature. This case study highlights the development, implementation, and evolution of Israel's national HIE network. What began as a vision within one health maintenance organization (HMO) about 20 years ago now connects most hospitals in the country as well as many ambulatory care facilities. At its center is a focus on using a de-centralized, federated network to deliver comprehensive, virtual medical records to clinicians on demand within their electronic medical record system for use in supporting patient care. The network evolved to support COVID-19 and other national priorities. Moving forward, the Israeli national HIE network will play a critical role in supporting the nation's digital health strategy, and will focus on advanced functionalities, including common clinical terminologies and advanced analytics. © 2023 Elsevier Inc. All rights reserved.