An article in Bloombergbusinessweek (April 7,2014) titled “Hospitals share data to prevent ER abusers”, describes an effort in Washington state to pool data regarding ER patient treatments to prevent wasteful spending. With 20% of patients accounting for over 4 ER visits per year, sharing data enabled ER patients with nonthreatening conditions to be treated elsewhere at lower costs, lowering visits to the ER by Medicaid patients 10%, and $33 million reduction in costs. Followup of ER patients with help for pain management is expected to improve care. Should such data sharing across competitors become the norm, or is this sharing only because nonthreatening conditions were dropped from ER reimbursement by the government? Will costs decrease and patient care improve with patient data sharing or do we need third party monitoring to ensure such outcomes ?