The American Recovery and Reinvestment act sets aside billions of dollars for electronic health records (EHR). While this funding may help fund the adoption of EHRs for many providers, there is an important piece of the eventual health IT infrastructure that has not yet received much attention: regional data sharing that can unify healthcare on a community level, provide quality reporting for consumers, and power a more transparent system. This paper examines these so-called chartered value exchanges and considers where they fit in the larger healthcare reform context and how they can help prevent a kind of health IT Tower of Babel.