Is there a right model?

There are many models operating around the country, and Yasnoff argues that duplication of efforts is a waste of time and resources. Koch is not ready to pick and choose.

"We're just not there yet to make a decision that we should only pursue one approach without consideration of the other because I don't think we understand how they can work together yet," she said.

Many regional HIEs have been moving towards a more consolidated statewide system; however, the federal government has been spending a lot of time and resources on point-to-point messaging. While Koch acknowledges that this kind of connectivity is important, she is somewhat disappointed that there has been less of a focus on robust, patient-centric and patient-consented HIE that requires strong governance.

"Without guidance from the governance perspective on a national basis, which hasn't taken off as quickly as many would have liked, there won't be any lightning speed deployment of real patient-centric HIE, which is being focused on in New York," she said.

Currently, New York is working to harmonize the state's regional efforts into a more consolidated, coordinated statewide system that can be a model for the rest of the country, Koch said. When that happens, the debate may very well take a different turn.