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Service-oriented architecture is an attractive development approach for flexible and reusable healthcare IT solutions. However, there are many practical architectural challenges in developing Service-Oriented Architectures (SOA) in organizations. In practice, not all basic SOA principles can be easily followed using vertical standards and local adaptation is typically needed. In this paper, we discuss balancing between vertical interoperability standards , local requirements and SOA principles.fatcat:yznl77jl3ngqfndzofsjvspgfa