As outlined in the letter (dated June 2017) from the NYSDOH, SHIN-NY regulation requires various healthcare organizations to connect to the SHIN-NY. Specifically, this includes Article 28 facilities, Article 36 facilities and Article 40 facilities. Organizations using Certified EHRs are subject to this requirement. If an organization is required to connect to an HIE and does not, they need to apply for a waiver from New York State DOH. It is vital to enable bi-directional data exchange in accordance with the New York State Department of Health. Data exchange is key for coordinating patient care and safe transfers of care.