C3HIE

What C3HIE does

C3HIE (Connected, Collaborative, Community – Health Information Exchange) is a Texas-based nonprofit 501(c)(3) Health Information Exchange headquartered in San Antonio. Founded in 2006, it operates a multi-regional HIE platform that aggregates and exchanges patient clinical data in real time among hospitals, physician practices, FQHCs/RHCs, behavioral health providers, EMS, and public health organizations across more than 128 Texas counties. The platform supports HL7 and FHIR standards, bidirectional EHR integration, Continuity of Care Documents (CCDs), Direct Secure Messaging, and connection to national interoperability networks including eHealth Exchange, CareQuality, Patient-Centered Data Home, and TEFCA (via eHealth Exchange's QHIN).

The product portfolio is structured as a core exchange platform with module add-ons: the Exchange product provides real-time data feeds and EHR-integrated lookups; Analytics delivers risk stratification, dashboards, and BI integrations with PowerBI, Tableau, Kibana, Salesforce Health Cloud, and HealthyPlanet; Alerts delivers real-time ER/admit/discharge/transfer notifications including CMS-compliant COP Alerts; and Partner Services covers EMS billing, CCM/PPM, and custom data delivery. Additional add-ons include Direct Secure Messaging, an A|D Vault Advanced Directives platform, an EHR-agnostic Patient App, and custom projects such as sepsis prevention. Security and compliance posture is a clear focus area: C3HIE was the first HIE in Texas to achieve EHNAC certification, is pursuing HITRUST CSF, operates in a SOC 2 Tier 1 data center, and complies with HIPAA and the 21st Century Cures Act.

The business model is built on subscription/participation fees paid by healthcare organizations that sign Business Associate Agreements and Master Service Agreements to join the network, with pricing not publicly disclosed and provided on a quote basis. Go-to-market is direct enterprise field sales targeting hospital administrators, IT departments, and physician practices across Texas, supplemented by public-sector partnerships (notably the City of San Antonio) and a 2025 bidirectional data-sharing agreement with the Texas Health Services Authority. Revenue is not publicly disclosed, and the organization is independently governed by a board of healthcare stakeholders with no parent company or external investors.

Name

C3HIE

Legal name

C3HIE

Website

https://c3hie.org

Company type

Private

Founded year

2006

Operating status

Operating

Headcount range

1–10 employees

Short description

C3HIE is a Texas-based nonprofit 501(c)(3) Health Information Exchange providing real-time clinical data exchange, alerts, analytics, and bidirectional EHR integration to 70 hospitals and 3,000 physicians across 128+ Texas counties.

Ownership category

akta.pro rank

Product category

Health Information Exchange

NAICS

Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (51821)

SIC

Services-Computer Programming, Data Processing, Etc. (7370)

akta.pro primary industry

HIE Platforms & Network Services (Community/Regional/National) (HLACABAB)

akta.pro secondary industries

Interoperability Standards, Profiles & Implementation (HL7/FHIR/IHE) (HLACABAA), EHR/EMR Integration & Interoperability Middleware (HL7/FHIR) (HLALAKAD)

Keywords

• Health information exchange
• Clinical data interoperability
• Patient record exchange
• Healthcare data analytics
• Medical record integration

Headquarters

HQ city

San Antonio

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Technology or R&D, Infrastructure, Personnel, Operations, Marketing or Sales

Revenue model

1. HIE Participation Fees: Healthcare providers, hospitals, and other organizations pay fees to participate in the C3HIE network. This appears to be a subscription-based model where organizations sign participation agreements to access and contribute to the health information exchange.
2. TEFCA Service Line: C3HIE plans to establish a new TEFCA service line with QHIN connection. Customers can opt-in to become Sub-participants through C3HIE's QHIN connection, with pricing aligned with other HIE services.

Go-to-market motion1 record

Distribution channels2 records

Marketing channels4 records

Core offering

C3HIE operates a multi-regional Health Information Exchange (HIE) platform that enables real-time electronic exchange of patient health records between hospitals, physicians, labs, pharmacies, payers, and public health agencies across Texas. The platform consolidates patient medical information through bidirectional EHR integration and HL7/FHIR data feeds, and supports national network connectivity through eHealth Exchange, CareQuality, Patient-Centered Data Home, and TEFCA. Supporting offerings include real-time alerts for care events, an analytics dashboard for risk stratification and population health management, and Direct Secure Messaging for encrypted provider-to-provider communication.

Product overview

C3HIE is a multi-regional Health Information Exchange (HIE) platform operating as a nonprofit 501(c)(3) organization that makes real-time health data available to healthcare providers across Texas. The platform follows a platform-plus-modules architecture centered on the Exchange core product, which provides real-time data feeds and bidirectional EHR integration. Supporting modules include Analytics (risk stratification, business intelligence dashboards, custom reports), Alerts (real-time notifications for ER visits, admissions, discharges), and Partner Services (EMS billing, custom data delivery). Additional add-on services include Direct Secure Messaging, Analytics Dashboard (web-based virtual health record portal), A|D Vault for Advanced Directives, Patient App for Providers, and Custom Projects for specialized needs like sepsis prevention. The platform also connects to national networks (eHealth Exchange, CareQuality, Patient-Centered Data Home, TEFCA) enabling data sharing across state lines. C3HIE currently serves over 128 counties, 70 hospitals, and 3,000 physicians across Texas.

Differentiator

Problem solved

Functional benefit

Products and services

• Exchange

Quantifiable outcome

• Supports 70+ hospitals and 3000+ physicians across 128+ Texas counties
• +2 more outcomes

Named customers10 records

Segments5 records

Ideal customer profiles5 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration14 records

AI capability1 record

Feature7 records

Partnerships

Six partnerships are on record, tiered core and moderate.

• Texas Health Services Authority (THSA)coreStrategic or Co-development Partner · 21 November 2025C3HIE and THSA finalized a bidirectional data-sharing agreement to enable real-time exchange of encounter event messages between their networks in Texas. This agreement aims to improve healthcare coordination and continuity for patients across the state by providing broader visibility into patient information and simplifying data integration. It is designed to create the largest health data pool in the state.
• eHealth ExchangecoreTechnology or IntegrationC3HIE participates in the eHealth Exchange national network and has announced intentions to join as a Sub-participant under eHealth Exchange's QHIN designation for TEFCA. The eHealth Exchange enables query-based document exchange, electronic case reporting, FHIR-based exchange, and push notifications for treatment purposes.
• CareQualitycoreTechnology or IntegrationC3HIE participates in the CareQuality national network enabling query-based document exchange, electronic case reporting, FHIR-based exchange, and push notifications across participating organizations nationwide.
• Civitas Networks for HealthmoderateStrategic or Co-development PartnerC3HIE participates in Civitas Networks for Health, connecting to Patient-Centered Data Home (PCDH) and other HIE-to-HIE connections for regional and national data sharing.
• City of San AntoniomoderateStrategic or Co-development PartnerC3HIE partnered with the City of San Antonio to increase vaccine access for elderly community members without internet access. C3HIE enabled waitlist management, forms, and API integration to identify and notify eligible community members when vaccines became available.
• Sequoia Project (RCE)coreStrategic or Co-development PartnerThe Sequoia Project serves as the Recognized Coordinating Entity (RCE) for TEFCA, responsible for development, implementation, and management of the Trusted Exchange Framework and Common Agreement. C3HIE participates in the TEFCA ecosystem through eHealth Exchange's QHIN.

Scale indicators4 records

Recent moves5 records

Expansion highlights6 records

Direct peers

• Manifest MedEx: California-based nonprofit HIE offering real-time exchange, ADT alerts, and population health analytics to hospitals, health plans, and providers. Directly comparable on nonprofit HIE model, alerts/analytics product mix, and cross-stakeholder governance.
• Greater Houston Healthconnect: Regional Texas HIE serving the Greater Houston area with hospital and physician data exchange, alerts, and analytics. Directly comparable peer competing for the same hospital systems and physician practices across Texas.
• Healthcare Access San Antonio (HASA): Texas-based nonprofit HIE serving the San Antonio and South Texas region. Directly comparable regional HIE operating the same exchange, analytics, and alerts business model and overlapping customer base (C3HIE's own helpdesk email is hosted on hasatx.org domains, indicating operational linkage).
• Healthix: One of the largest public HIEs in the US, serving New York State with bidirectional exchange, alerts, analytics, and public-health reporting. Comparable as a large-scale nonprofit HIE monetizing alerts/analytics on top of core exchange infrastructure.
• Indiana Health Information Exchange (IHIE): Pioneering nonprofit HIE providing clinical messaging, results delivery, and population health analytics across Indiana. Directly comparable on nonprofit HIE model, multi-decade operating history, and analytics-as-revenue extension.
• Texas Health Services Authority (THSA): State-level Texas HIE authority that just signed a bidirectional data-sharing agreement with C3HIE. Operates in the same regulatory and provider ecosystem in Texas, with overlapping mandate around state-level health information exchange governance.
• Health Information Exchange (HIE) of CRISP: Maryland-based nonprofit regional HIE providing real-time ADT alerts, encounter notifications, and analytics to hospitals, providers, and public health. Closest functional peer by structure: regional nonprofit HIE monetizing alerts, analytics, and a public-health utility role.

Broad incumbents

• Carequality: National interoperability framework enabling query-based exchange, electronic case reporting, FHIR exchange, and push notifications. Functions as both an interoperability partner and a broad incumbent that competes with HIEs by enabling direct EHR-to-EHR exchange.
• eHealth Exchange: National QHIN network that C3HIE participates in for TEFCA. Functions as both a partner and broader incumbent enabling query-based document exchange, electronic case reporting, FHIR exchange, and push notifications across the country.
• CommonWell Health Alliance: National EHR-vendor-led interoperability network that C3HIE provides indirect access to. Competes as a broad incumbent by embedding record-sharing inside major EHR workflows (Epic, Cerner/Oracle, athenahealth, etc.).

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/C3HIE

Compliance6 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about C3HIE