Healthcare coordination has proven difficult to achieve, even with new coordination technologies such as shared electronic health records. Successful coordination requires alignment of information technology with new organizational structures, reskilled personnel, and reengineering of work processes. We suggest that this is more challenging in the healthcare industry as a result of the need for integrating information across care cycles, payment and regulatory mechanisms, high degree of professional control, failure impact and privacy concerns, and information granularity across the care cycle. We illustrate these challenges with several examples from a qualitative study of the integration of electronic health records between hospital and ambulatory practices. \