Alabama has created a statewide Health Information Exchange called One Health Record to facilitate the electronic sharing of patient health information between providers. One Health Record allows secure exchange through a central hub and connections to provider electronic health record systems. It supports over 1 million patients and connections to other state exchange networks. Future plans for One Health Record include expanding hospital, community health center, and long-term care facility connections, as well as interstate exchange with neighboring states and national networks. Challenges to ongoing development include ensuring sustainability, improving provider adoption and workflow integration, and achieving full interoperability between different electronic health record systems.