James Ehlich Jr., a private-practice physician in Indianapolis, began receiving test results from IHIE via fax in April. By summer, he was downloading reports electronically from IHIE's portal.

Ehlich said the electronic system delivers reports a day earlier than the fax-based system, and it has enabled him to stop receiving some duplicates. In addition, the consistency of the reports has improved, he noted.

Ehlich did cite one drawback of the new system: He can retrieve only tests that were ordered by him or his partner. And since 95 percent of his patients are referred by other physicians, he often needs to see the results of tests requested by those doctors, he said.

Those regulations can force him to retest patients or postpone appointments while waiting for results to be sent by other doctors, Ehlich said.

Overhage said the fees generated by the clinical messaging service are critical to the "long-term financial viability" of IHIE. Those funds will be used to bolster the not-for-profit IHIE to a cash-positive position in the first quarter of next year and will provide a foundation to pay for building additional services.