This report attempts to relate the first year's experience of the Kentucky, Ohio, Michigan Regional Medical Library (KOMRML). Ten academic institutions in Kentucky, Ohio, and Michigan (KOM) are supporting an agreement signed on May 1, 1968 to form an organization with the general objective to work toward making the resources of each of the participating institutions' health sciences library accessible to KOM. Although there is as yet no way to measure the success of the KOMRML decentralized approach, the regional network is functioning. An organization has been formed encompassing a geographic region 1,000 miles long by almost 500 miles wide that includes nearly 10% of the nation's health professionals. KOMRML is serving as a mechanism for responsible institutions to contribute to national goals. (MF)