Advances in information technology during the past decade have resulted in a proliferation of clinical information systems dedicated to different user groups and clinical functional areas. This, in turn, has created the need for hospital-wide management and integration of information, and has triggered major efforts towards the development of integrated hospital information systems as a building block of integrated regional healthcare networks. The diversity of hospital organizations, the complexity of clinical protocols and procedures, as well as the different preferences of various user groups make it extremely difficult for a single monolithic information system to effectively serve the needs of an entire healthcare organizational structure. Thus, information and telecommunications systems must primarily provide the infrastructure to support the effective integration of distributed and heterogeneous components, ensuring overall integrity in terms of functional and information interworking. This approach i.e., the integration of heterogeneous autonomous distributed systems, to developing and managing regional healthcare networks ensures the transfer and integration of consistent information between healthcare facilities, without imposing constraints on the operation of individual clinical units. This paper presents the results of an ongoing effort for the design and implementation of an architecture based on digital library technologies, for the provision of user oriented telematic services in a regional healthcare network. Specifically, it addresses issues related to the provision of user-oriented services, transparent to the needs of different user groups and the requirements of specific tasks, based on: a) meta information for the creation of an information infrastructure for the regional healthcare network which is, effectively, a multimedia distributed digital library, b) intelligent information retrieval strategies to selectively retrieve information from multimedia data, c) agent-based technologies for effective service delivery adapted to the current user needs and the task at hand, and d) middle ware services that explicitly reveal not only the characteristics of the information sources, but also address the context of specific telematic services, through appropriate mediation mechanisms. © Springer-Verlag 1997.