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The presentation describes the experience gained from building a SOA (service Oriented Architecture) based production health care system for the OSU (Ohio State University) Medical Center. The system uniformly treats collection of “medical actions” as generalized electronic medical records. One part of the system allows us to securely and in near real time monitor, record, and replay clinical data being generated in the 50+ ORs at the medical center. Another part of the system (currently under construction) allows patient and equipment tracking by utilizing the existing wireless infrastructure at the medical center. The presentation describes the use of emerging open specifications based on policy to enhance a federation of SOAP XML Web Services. Maintainability is enhanced because declarative security policy enables separation of security concerns from business logic. The system initially used Microsoft’s Web Services Enhancements (WSE) 2.0 implementation of WS-Policy, WS-Trust and WS-SecureConversation open specifications; currently the system is being ported to Microsoft Indigo. The presentation describes patterns of using Web Services in a near real time environment and how using WSE/Indigo can significantly decreased the cost of building and maintaining a secure policy based federated system. ©2005 Microsoft Corporation. All rights reserved.