Norwegian competence centers in ICT and health are gradually disappearing. If competence centers in e-health are to succeed in the longer term, they must develop an independent perspective on needs and opportunities in the health service. Preferably at the meso level (knowledge of local cooperation challenges) and at the micro level (tasks and information flow at practitioner level). The experience is that knowledge about this is insufficient in the directorates and with other subcontractors to the ministry. Experience with large shared clinical record solutions is that they are sub-optimal for most services. General practitioners have the most important coordination function in the health service, and have been successful in being central to the development of systems tailored to their role.