Primary care providers are strongly integrated into the HIE, and the exchange has already begun to streamline care transitions and provide physicians with deeper, valuable medical profiles of their patients, but Khurshid and DeSalvo are looking to put the exchange to greater use in the coming quarters. 

They cite a need for the integration of a patient's behavioral health with his or her medical profile. In some cases, privacy and legal issues prevent this synthesis; Physical health providers are often prevented from engaging with a patient's behavioral health record through an exchange. 

"We have worked with the city health department and Dr. DeSalvo and our community partners to start implementing health projects that try to bring behavioral health data with medical data," said Khurshid, emphasizing the importance of holistic health records to ensure proper, whole care for an individual. 

DeSalvo, too, is looking to improve the cost system surrounding the exchange. She hopes to delineate the ways that HIEs can generate clear returns on investment, and grapple seriously with: "Not just how are we going to pay for it, but how are we going to make it something that saves the health system money, as opposed to just adding cost?"

Abebe, Khurshid and DeSalvo agree that these changes will come – especially through the collaboration that marks the Greater New Orleans community. LPHI is looking ahead to working continually with advisory boards, increasing consumer engagement and the overall addition of "trust capital" to generate the care practices that the community is asking for. 

"In each of the areas of people, processes and technology, we have challenges," said Khurshid. "The most important challenge to address is people, because people have to change. People change when they see the value. In order to work together they have to have trust. But you can choose to call this a challenge or an opportunity."