Managing public health care organizations is becoming more demanding and complicated task. The ever-increasing demand for health services and at the same time substantially decreasing resources sets new challenges to the area. Expectations towards information systems (IS) are high and it is seen as one solution to increasing problems. However, it is noticed that also development of IS needs professional management and strategic planning to become an effective tool — again a new challenge to the management.

This paper discusses which are the main management areas to pay attention to in IS development in public health care and which factors in the operational environment affect those areas the most. The areas are: organisations strategy, information management strategy, strategy implementation, implementation and use of IS and evaluation of IS. Results from two large empirical cases show that developing IS in public health care is far more complicated because of a wide operational environment and number of stakeholders compared to the development in other public areas not to mention private industries. The paper is based on experiences in Finnish public health care.