The Rhode Island Quality Institute (RIQI) got its start about eight years ago with a number of mandates like improving safety in Rhode Island Intensive Care Units. RIQI later began an electronic health record (EHR) adoption program for providers. When regional extension centers were created last year, the RIQI became the REC for Rhode Island and is the statewide health information exchange, called currentcare. The RIQI is also the recipient of the Beacon Community grant and the State Health Information Exchange Cooperative Agreement Program Award. RIQI’s chief operating officer and chief information officer Gary Christensen spoke to Healthcare Informatics associate editor Jennifer Prestigiacomo about his REC’s innovative marketplace approach to helping providers choose an EHR vendor, and he also shed some light on how he’s dealing with his REC’s sustainability issues.