Through a grant from the Blue Shield of California Foundation, the Northern Sierra Rural Health Network (NSRHN) will be implementing initiatives, based on assessment of community needs. NSRHN, a consortium of 46 providers, serves nine counties in Northern California in which 80 percent of that region is considered rural or frontier. NSRHN will introduce the NEPSI, or National ePrescribing Patient Safety Initiative, model of e-prescribing.Through NEPSI, participating physicians will be able to e-prescribe at no cost to them. NSRHN’s regional disease management initiative will focus on diabetes and collect health information through the clinics and rural hospitals. Lastly, NSRHN will provide remote access to health information for its providers to better serve their patients. Sonoma County is known to many as wine country. Many agricultural workers contribute to the area’s wine production. Thanks to a collaboration among Vineyard Worker Services, St.Joseph Health System of Sonoma County and Community Health Resource & Development Center formed in 2002, agricultural workers and their families who opt in now have portable, secure personal health records that travel with them wherever their work takes them. MiVIA makes it possible for physicians to access patient health information, gives workers and their families relevant health information and provides links to community resources and clinics so patients can easily find healthcare services. The MiVIA system has been so successful and heavily used by agricultural workers and their families that it is being expanded and licensed to other areas of the country, including the Central Valley and Humboldt County in California, Hood River in Oregon and the Finger Lakes region in upstate New York, according to Kathy Ficco of St.Joseph Health System. However, with grant funding drying up, the program relies on St.Joseph Health System to support it. Camino de Salud developed an integrated operations network that enables health information exchange for providers to deliver coordinated care for their managed care Safety Net patients in Central and East Los Angeles who opt into the program. The Long Beach Network for Health, which was granted a trial implementation contract for NHIN development, is now merging the operations of the Camino de Salud model with a Web-based cross-organizational HIE to continue providing quality healthcare but also to provide a sustainable business model.