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I'm an applications architect with a public sector health agency. The current task is to connect a private hospital to enable health information integration. According to the network team, the private hospital are both using private IP addresses (RFC 1918) and this means the private hospital to readdress servers (change static IP addresses) to prevent the possibility of address conflicts in the future.

This has become a major dependency and probable a delay in the integration project.

This whole idea seems bizarre to me. Given that the integration of new private partners will be a repeated need over the future what would best practice be, i.e. to allow each agency and hospital to have a private address space and use that without fear of address conflict.

Is Network Address Translation (NAT) the answer (the network guys say this will be inefficient) or is there something better we should be moving toward?

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it’s hard to say without more details: what is the subnet of each hospital. do they need to be fully integrated or just one hospital needs to access some services in the other side and vise versa. what overlay are they going to use ( WAN or public internet ...)