The Mid-Ohio Valley Rural Health Alliance (Alliance) is a vertically integrated network founded in 1998. The founding members of the Alliance came together to develop programs and processes to reduce cost and improve efficiencies as a group. The Alliance has been the recipient of several grants, including the Healthy Communities Access Program (HCAP) and implemented programs to improve services to patients with chronic conditions. The current focus is on improving access to healthcare, reducing the severity of chronic conditions, and fostering a patient-centered environment promoting patient self management. The goal of the organization is the development and implementation of a shared electronic health information system, for the purpose of improving the quality of care by giving providers accurate and complete information about their clients at the point of care, increasing the productivity of providers by providing all relevant health records in a timely manner, enhancing the continuum of care, reducing costs and empowering patients to become a part of the care team.