The drivers of institutional change in health care can be traced in part to technology and in some degree to globalisation and to various interactions between the two. Three papers collected under the banner of Health, IT and Globalisation and published in the Y2K issue of Annual Review of Health Social Sciences provide substance for reflection regarding the challenge of factoring 'globalisation' into our analyses of the processes of institutional change in health care. These three case studies of institutional change deal with the corporatisation of general practice, the rise of e-health and work intensification in nursing. It seems self-evident that analysing such case studies in relation to globalisation is a worthwhile project. However, it is not self-evident how to proceed with such an analysis: what directions should guide it and what are the disciplines involved. In this (invited) commentary I explore the challenges of analysing such instances of local institutional change in relation to the structures and dynamics of globalisation.