Texas HIEs to Share Encounter Event Messages

Because of its size, Texas was never going to have just one health information exchange organization. But getting regional HIEs there to share data has also proven challenging. Now two of Texas’ largest health information exchanges – C3HIE and Texas Health Services Authority (THSA) – have signed an agreement for bidirectional sharing of encounter event messages for treatment purposes. 

Currently serving over 128 counties, C3HIE is a multi-region nonprofit collaborative connecting healthcare providers through secure bi-directional health information exchange with ADTs, lab results, imaging results, notes, and CCDs. THSA is a statutory organization to promote and enable interoperability across Texas. It accomplishes this purpose through its state-level health information exchange (and privacy and security certification and supporting programs).


For the first time, participating organizations will receive encounter information from across both networks, giving clinicians and care managers a more complete picture of a patient’s health journey, THSA said.  Subscribers will gain comprehensive event notifications from both HIE networks without the burden of managing multiple connections, integrations, or vendor relationships. The unified approach reduces administrative complexity while expanding the reach and value of the data available to support clinical and operational decision-making.

Phil Beckett became THSA’s CEO in January 2025. He had previously served as CEO of C3HIE. In an interview with Healthcare Innovation a few months ago, he explained that THSA was created in 2007 primarily in response to Hurricane Katrina, when a lot of people evacuated from Louisiana to Texas without their medical records, and physicians were trying to take care of them. “People said let's have something in Texas that promotes interoperability,” he explained. “Then when the ARRA funding came in, Texas got about $25 million from the federal government through the HITECH Act to fund THSA, and the approach was to support regional HIEs. Texas is so big we wanted a regional model, and 12 got funded at the time.”

The idea was the regions would connect locally, look after their own communities, and then they would connect centrally through THSA to share data between them. But for those 12, sustainability was a challenge, he noted. “It’s a tough business model, and some of them just simply didn't make it,” Beckett said. Now the state is down to five regional health information exchanges. 

And the vision of having regional HIEs share data with each other didn’t happen the way it was envisioned, but Beckett and THSA continue working toward that goal. “I came from a regional health information exchange, and I thought maybe I could help get back to this model of everyone working together,” he said. “There are some state incentives that have encouraged that as well. Texas Health and Human Services has worked hard to try and get hospitals, payers, and health information exchanges aligned.”

THSA added that the door is open for all HIEs to participate and grow this network.