Governance of the highly decentralised Italian Health System is based upon the provision of "Essential Levels of Care" to all citizens. Regions must organize own services preserving at the same time efficiency and equity, but the planning capacity is heterogeneously distributed across the country, as well asthe ability to achieve "Essential Levels of Information" for routine monitoring. Regione Abruzzo, currently involved in a special program for cost containment, has established an interistitutional group to build a targeted health information system. Results include an agreed specification of common priorities, privacy-protective rules for data harmonisation, information exchange and statistical analysis, and a roadmap for action by policy makers. The approach can be usefully applied to overcome organizational barriers typical of decentralisation.