For various reasons, patients seek care at different hospitals within a region, resulting in fragmented medical records at the point of care. In the emergency department, this is a particularly important issue because the emergency department provides open access to all patients and requires rapid high-stakes decision making to function well. To address these issues and as a result of federal initiatives, health information exchanges (HIEs) have been designed and implemented in various regions throughout the United States to promote health information sharing. The use of HIEs has been demonstrated to lower costs and avoid duplicative testing and treatment; however, obstacles such as physician usage characteristics and institutional concerns regarding information sharing exist and must be addressed before full implementation and adoption of HIEs among institutions take place. Further research is needed to describe the benefits of HIEs and how they can affect these barriers.