Organizational models: from institutional to supra-national responsibility for health information systems

Internationally as well as within a given national environment, there are many variations in the organization of health care, hospitals and hospital information systems. This paper attempts to structure the diversity by examining determinants of organizational models. These show an increasing need for inter-institutional coordination and cooperation. An examination of organizational components shows that those at the institutional level are increasingly complemented by components at the national, international and global levels. Hence, organizational models do not only have to be dynamically responsive to changing requirements arising from changes in determinants, but more importantly, inter-institutional and supra-institutional organizational structures gain in importance.