Sharing information across organizational boundaries is central to efforts to improve government operations and services. However, creating the capability necessary to enable information sharing across the boundaries of organizations is among the most difficult types of information technology projects. New knowledge about information sharing is required; in particular, new understanding about how government, non-governmental and private sector organizations come together to share information is necessary. This chapter draws on the experiences of key actors in three states in the United States as they organized to create new capability to share information as part of their responses to the West Nile virus outbreaks. The cases highlight the gap between expectations and reality, providing opportunity to more fully understand the gaps between expectations (the hype) about ICTs and the reality facing government practitioners who seek to use ICTs to share information. Examining the cases in terms of four contexts of information integration and sharing provides a more specific understanding about the gaps between these expectations and the reality (after the hype). The lessons learned in the context of public health include the central role of information sharing and the implications of resource constraints on data capture and use capability in the context of an outbreak management and surveillance effort. Insight into the interdependence of system design and process support and improvement in the context of public health surveillance was also found to be critical to future planning of public health surveillance systems. This chapter serves to reemphasize to both researchers and practitioners the need to close the gap between expectations and reality; the point is made again through the cases that closing the gap depends on strategies that draw on technology, process, interorganizational, and political perspectives and resources.