Robert Steffel, Executive Director, HealthBridge, Inc., Cincinnati, reviews the drivers and success factors that have enabled clinical information sharing in this market, and lessons learned during their several years of operation. HealthBridge was created in 1997 by the Greater Cincinnati healthcare community as a utility for connectivity and interoperability. Today HealthBridge is one of the most successful regional health information organizations in the country. The RHIO operates a community-wide physician portal and clinical messaging application that delivers over one million clinical results to more than 3,000 physicians each month. Perhaps HealthBridge’s most significant accomplishment is that it was created with community funding (no grant money), has achieved a self-sustaining business model and has demonstrated an ROI for its health system sponsors.