Readily available images, whether included in an EHR or a residing in repository, can improve care by reducing unnecessary tests, and lowering patients radiation exposure. Theres also a business case for image exchange, especially among HIEs trying to differentiate their services from competitors. In New York, Rochester RHIO was among the first HIEs in the U.S. to offer image exchange, but now its neighbor, the HealtheConnections RHIO, has joined the image exchange club.