The Inland Empire Health Information Exchange (IEHIE), which recently went live in southern California, stands the debate over public vs. private HIEs on its head: Although it’s a regional HIE–one of the largest in the country, in fact–it also serves as an enterprise HIE for some of its participants. Coupled with the fact that the exchange is already financially self-sustaining, this hybrid model carries some lessons for struggling community HIEs elsewhere in the nation.