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The Metro DC Health Information Exchange (MeDHIX) was established in 2004 with a one-year planning grant followed by a three-year implementation grant for the purpose of linking safety net providers regionally. Both grants were funded by AHRQ. The grant-funded efforts to establish a multi-jurisdictional regional HIE in Maryland, the District of Columbia, and Northern Virginia. The focus of the work was to link safety net providers caring for low income uninsured and under-insured patients for sharing electronic health information.