This contribution aims to analyze the evolution of the Information and Communication Technologies (ICT) projects of the Local Health Authority of Reggio Emilia, concerning the implementation of the electronic medical record. Since the early 2000s, the pre-existing Local Health Authority and Hospital Trust of Reggio Emilia have developed an integrated ICT culture and strategy, based on three key points: 1) alignment with corporate strategy; 2) project management approach; 3) measurement of the results and value produced by the implementation of ICT innovations. The IT Steering Committee was created with the tasks of defining the three-year ICT strategies and monitoring the results of the projects. One of the most relevant projects was the “Matilde” medical record implementation, initially activated at the Hospital Trust in 2013 and extended, after the merger in 2017, to the other 5 hospitals. This project, completed in 2021, aimed to create a unique tool for managing the hospital’s clinical path. During the Covid-19 pandemic, the use of medical records was extended to private clinics and accredited public and private territorial structures. Today, the Local Health Authority of Reggio Emilia is starting a process for the implementation of a Community, social, and health care record, shared by all public and private entities in the province.