Information exchange is a cornerstone in facilitating a strategic advantage in business. However, health information exchange has not shared that same foundation in health care and related secondary uses, especially when the information is used for something other than diagnosis, treatment, or payment. This case study provides an in-depth examination of successful health data sharing for disability determination between three organizations: the US Social Security Administration (SSA), MedVirginia (a Health Information Exchange (HIE)), and the Office of the National Coordinator (ONC). In this case, use of SSA's MEGAHIT application (Medical Evidence Gathering and Analysis through Health Information Technology) and ONC's Nationwide Health Information Network (NwHIN) facilitated the electronic health data sharing from MedVirginia's electronic health records (EHRs). A Blended Value Collaboration Enactment Framework was used to understand the overall value proposition (answering the organizational question: "What's in it for me?") from both social and economic perspectives along technical, organizational, and governance dimensions. This qualitative study consisted of 41 interviews and document analyses across the three organizations over a six-week period from July 2010-September 2010. Primary findings revealed that social motivations were prevalent in the original collaboration and a blend of social and economic motivations sustained the collaboration. Further findings showed that, as compared to previous medical evidence development methods, the use of MEGAHIT resulted in a 33% time savings from disability application to SSA benefit approval. Such SSA benefits led to $1.9 million in uncompensated care cost recovery for the provider. Supporting findings revealed that regular and consistent communication and structured governance are essential for creating a sustainable health information exchange collaboration. The findings illuminate the dynamic nature of social and economic blended value such that early motivations in health information exchange may not be the sustaining motivations; at some point in time a shift toward economic value occurs. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]