In order to create value for customers efficiently and to avoid unnecessary or redundant activity, organizations need IT support that interacts well with their business processes. In addition, healthcare organizations require transparent communication between the various actors and between IT systems. A new type of process oriented integration architecture has been developed using software devices known as process managers. These use simple graphical models to visualize business process integration and facilitate its management and monitoring. This article discusses the benefits and difficulties of introducing process manager technology into healthcare, based on a project to integrate IT systems over the patient process and across several organizations. Particular problems are caused by communication across organizational boundaries, e.g. due to security issues. However, the technology is able to manage and monitor processes and to make communication simpler and safer.