Furthermore, the use of RHIOs can make it very difficult for the national health information network to identify errors in health information and processes used by healthcare organizations in different areas, whether RHIOs are employed to achieve compliance ambitions. Another disadvantage is that, as a strategy to address patient privacy and safety concerns, health information organizations have been established to enable the secure and integrated sharing of health information between various stakeholders, not excluding clinical partners and public health (Shapiro, Mostashari, Hripcsak, Soulakis, & Kupermann, 2011). However, RHIOs are still grappling with security, data storage, technical support, and overall patient index issues, and these conditions may limit the effectiveness of the exchange in the future if they are used to achieve NHIN's goals.