Due to local idiosyncrasies and professional variations in the capture and use of patient infor-mation, healthcare providers often struggle to facilitate smooth transfer of patients along with essential information about them. This puts pressure on national and regional authorities to consolidate e-health standards, but they often lack the legitimacy, capacity or mandate to im-plement significant changes. We have looked at the rather successful governance of e-health standards in one health region in Norway. Through the establishment of a coordinative network, health professionals share knowledge and continuously improve e-health standards across hos-pitals in the region. We conceptualize the phenomenon as an adaptive network-oriented stand-ards governance model for very large information infrastructures. For e-health standardization practitioners, we advise that the inherent consolidation problem in standards governance in healthcare may be mitigated through the establishment of profession-based network groups that can mediate between top-down and bottom-up standardization activities. Theoretically, we con-tribute with a fresh standards governance model, which takes into account the process, struc-ture and technical perspectives necessary to manage large-scale standardization efforts.