Information and communication technologies (ICT) are now part of the fabric of the global economy, however the adoption of ICT in the health sector has been significantly slower. The traditional drivers of adoption in the business sector are not always present in the health sector and there are a number of systemic inhibitors that make the adoption of ICT far more complex. This paper examines strategies that can be used to manage these complexities using a case study of a successful implementation of electronic health records in remote Western Australia. The desire for improved health outcomes by those involved overcame bureaucratic, technical and cultural barriers to the effective ICT adoption and use.