| Tier and Category | Details |
|---|
| Tier 1 | Tiny Institutions - Minimal use. |
| 1.2 | Medical | Private practice office or private clinic. |
| 1.4 | Medical | Residency program (independent from larger institution - on site access only). |
| Tier 2. | Small Offices, Colleges, General Research, Reference or Charitable Institutions |
| 2.3 | Academic or Medical | Nursing school or allied health training program (e.g. chiropractic, physical therapy). |
| 2.4 | Medical | Community hospital or clinic, (may have a family practice or nursing residency program, but not a major teaching or clinical research facility). |
| Tier 3. | Core Research Organisations or Institutes - Localised but not exclusive |
| 3.1 | Academic | Doctorate-granting research University |
| 3.2 | Academic/Medical | Medical School |
| 3.3 | Medical | Major teaching or research hospital (medical school affiliated, multiple residency programs). |
| Tier 4. | Large, Regional, Networkes Single Organisations - country or area specific. |
| 4.2 | Academic, Medical or Public-Non-profit | Private non-profit research organization or Healthcare network, (single institution with regional campuses, such as the Mayo Clinic, Kaiser Permanente's California Division, or The Carnegie Institution). |
| Tier 5. | Very Large Institutions, or Groups of Institutions - no boundaries. |
| 5.1 | Academic | Consortia of academic libraries/University consortium or shared network/State or National site license (such as the California Digital Library, OHIOLink, UKB, NESLI, BIBSAM). |
| 5.2 | Medical | Consortia of medical libraries and affiliated hospitals. |
| 5.3 | Academic, Medical, Public-Non-profit Government or Corporate | A group of affiliated labs or regional buying groups, not a single institution/State or National site license. (e.g. The NHS Trust in the UK, INSERM in France). |
| 5.4 | Corporate | Large for profit organization, (e.g. multinational Corporation - such as Bell Labs, Pfizer, Merck). |
