Irresistible economic and technical forces are forcing healthcare institutions to develop regionalized services such as consolidated or virtual laboratories. Technical realities, such as the lack of an enabling enterprise-level information technology (IT) integration infrastructure, the existence of legacy systems, and non-existent or embryonic enterprise-level IT services organizations, are delaying or frustrating the achievement of the desired configuration of shared services. On attempting to address this matter, we discover that the state-of-the-art in integration technology is not wholly adequate, and itself becomes a barrier to the full realization of shared healthcare services. In this paper we report new work from the field of Co-operative Information Systems that proposes a new architecture of systems that are intrinsically cooperation-enabled, and we extend this architecture to both the regional and national scales.
