Health Information Exchanges (or HIE's) have sprung up in recent years as a mechanism to facilitate the transfer of patient medical records between care providers. They are an extension of the EMR system, an area in which the Federal Government has poured millions of dollars over the past few years. Yet this brand new survey shows the problems that persist with HIE's. Customer satisfaction ratings have declined for 10 out of 11 of the major HIE vendors in the US according to the survey cited by this article.