Health information technology is often assumed to improve healthcare. However, expectations of health information technology are seldomly met in full for multiple reasons. While the implementation of health information technology, is increasingly being investigated and evaluated, less attention has been paid to the preceding choices made by key people on how to share relevant information in new HIT systems. This study brings to light the central considerations exercised by key people in charge of managing the process of how to share information through locally developing new digital systems for quality information management. The multiple decisions revolved around three main considerations: user conditions and role, integration into local setup, and resources. Weighing the cost benefit balances of these perspectives are likely to influence subsequent access to and use of high-quality information in public healthcare and are therefore central to the management of effective health information technology.