California, like most states, is in the process of creating two new health exchanges — one for insurance and one for information. The two are closely related, somewhat dependent on each other and will have to work well together from birth for either to be successful. On one hand, California finds itself in familiar territory as the front-runner in these two new, uncharted efforts. As an early believer in the value of health information technology and the ability to share information, California formed Cal eConnect more than a year ago to oversee the sharing of electronic health information. Last fall, California was the first state to pass reform-driven legislation to create a health insurance exchange.