Interoperability has been maddeningly elusive, however. One reason, of course, is exactly the competitive "closedoffedness" CommonWell says it's working against. Another, Elmore suggested, might be that some are trying to do too much, too soon.

"A lot industry efforts are trying to boil the ocean," he said. "I think we've stayed really focused: at the point of care, a secure method to be able to find out where the patient's records are and allow the doc, on a targeted basis, while complying with HIPAA, to be able to ask for that record to be sent back."

One vote of confidence for CommonWell also came at HIMSS14, with the announcement that Tenet Healthcare – with its 77 hospitals, spanning 14 states – will make use of the alliance's services.

Beyond the early encouragement from the initial pilot participants, Tenet's heft and reputation would seem to bring some critical mass on the provider side. CommonWell's work with the hospital giant will focus on patient ID and matching, record location and document query and retrieval services.

"Tenet is committed to advancing technology with our hospitals and health care networks to ensure we’re providing the right information when and where it’s needed, enabling our providers to increase the efficiency and accuracy in care delivery and improve the quality of care in the communities we serve," said Bo McPartland, Tenet's vice president of IS planning and analytics, in a statement. "We look forward to working with CommonWell in breaking down the health data silos that exist today."

"Tenet is making a commitment to work with us to use the service," said Stuewe. "At this point, that's a huge statement about their commitment to interoperability. As you get more people involved, the momentum picks up and some of the barriers drop. It's a great vote of confidence that they're willing to work with us."

Going forward, "We are absolutely committed to embracing as many folks in health IT as possible," said Elmore. But that growth may just have to proceed somewhat deliberately.

"We're still just a group of volunteers," said Stuewe. "We don't have a lot of staff in the organization yet, and so, as a consequence, our ability to onboard dozens of members at this time is going to be challenged. We are trying to figure out what our demand is so we can get staff for when people really want to start joining. We need to have membership services in place so people can really get what they need from us."

In the meantime, providers are waiting and watching. And those who are already participating are looking ahead to what comes next.

"We see benefit here," said Williams. "We obviously have a real interest on the patient side; they're understanding what we're doing, so we really want to follow this. It'll be something that will further bring the hospital, the provider and the patient all into the same world – all for the good of the patient."