True reform of the healthcare system will depend on having clinical data points available upon which to make decisions. At this point, clinical data exchange remains mostly theoretical; even the exchange of administrative data is fraught with challenges. In order to get the right incentives in place through both meaningful use and payment reform, we need a very focused and deliberate plan moving forward. We are making progress -- but it must move faster. Gain insight into what levers are being considered and pulled in order to help realize the promise of health information exchange.