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The North Carolina Healthcare Exchange (NCHEX) is a voluntary health information exchange (HIE) of hospitals and physician practices sponsored by the North Carolina Hospital Association (NCHA) to enable healthcare providers across North Carolina to share clinical data with each other to meet Meaningful Use exchange requirements, improve quality and reduce costs. NCHEX builds on the experience and technology of the North Carolina Hospital Surveillance System (NCHESS), created in 2004 as a public-private partnership between NCHA and the North Carolina Division of Public Health (NCDPH) to provide critical data from 123 emergency departments to enable the state to recognize and respond to acts of bioterrorism, disease outbreaks, emerging infections, and other public health emergencies. To date, North Carolina hospitals have exchanged over 223 million records regarding 35 million ED visits using the NCHESS system. NCHEX uses proven technology from CareEvolution, who provides HIE services in Indiana and for the South Carolina Health Information Exchange (SCHIEx). In partnership with Truven Health Analytics, this technology is used for statewide HIEs in West Virginia, Georgia, Alabama, and Pennsylvania.

NCHEX Overview

What is NCHEX?

  • NCHEX is a voluntary health information exchange (HIE) from the North Carolina Hospital Association (NCHA). The exchange is open to all North Carolina medical providers to join and actively seeks to connect with existing RHIOs / HIEs / HIT systems in North Carolina by leveraging the eHealth Exchange and other HIE standards.
  • The exchange will support a secure patient-centric “Continuity of Care” view for providers.
  • NCHEX is built upon existing NCHESS infrastructure to reduce HIE costs and implementation times.
  • The exchange is planned to support multiple Meaningful Use requirements around interoperability for hospitals and eligible professionals. 


  • Leverages existing statewide NCHESS investments to rapidly and inexpensively launch a statewide HIE.
  • Unlocks existing data assets to pre-populate the HIE and thereby improve patient care statewide.
  • Supports hospitals and eligible professionals to achieve Meaningful Use in a cost efficient manner.
  • Supports sharing of information between hospitals, physicians, and other care providers.
  • Connects with and leverages existing community HIEs / RHIOs to rapidly expand HIE reach and coverage.

We envision NCHEX connectivity that includes the following capabilities:

  • The ability to assemble a patient-centric continuity-of-care record composed of information from all NCHEX participants, which can be displayed at the point of care via secure web access and EHR system linkages.
  • HIE exchange functionality between providers to support care coordination (referrals/ messaging).
  • eHealth Exchange connectivity.
  • Access to hospital inpatient and outpatient claims history including all episodes in North Carolina for the last 3 years.