A sample of 40 from 176 public policy organizations in Washington, DC, was studied. The organizations were those whose leadership was deemed necessary to develop a new strategic vision of electronic technologies to support public health. The results showed that large, secure and well positioned organizations became active only to the extent of their mandates, while smaller and less influential groups, which were freer to think and act innovatively, had an incentive to work with other organizations to gain effective support for their policy positions. The conclusion is that the constituencies of leading policy organizations will have to ensure that well connected leaders and environmental scanning structures guide their organizations and that they have the institutional capacity to develop unconventional strategies to meet health challenges.
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