This paper promotes nurses increased opportunities for active participation in the implementation of the healthcare system with special attention to implementation outside clinics, in patient's homes. The aim is to increase understanding of which rationality that underlies implementation with examples from two international projects implementing health care systems in several European countries 2012-2015.Starting up with the discourse on linear and integrated care four factors related to rationality are discussed: time planning and project progress; the elicitation of user needs; evaluation methods and safety and security as more than technical data. To balance technology and health care needs the use of a caring- or context rationality is suggested.