The purpose of this research was to explore the current debate about ‘Best of Breed’ (BoB) vs. Enterprise-wide (EW) Information Systems (IS) in New Zealand healthcare. The ehealth landscape is diverse with hundreds of systems ‘wired together’ in a complex puzzle. Method Strategic ehealth documents were analysed and 14 senior IS executives from different organisations were interviewed. Findings There appears to be agreement about (1) what the concepts mean, (2) the problems caused by the mix of BoB and EW, e.g. the strong influence of clinicians on IS decision making, and (3) a possible solution to the complex puzzle lies in changing the mix to emphasise patient-centric ehealth. However, when discussing to what degree information systems should be customised and/or centralised disagreements become visible. Discussion and conclusions There is a trend towards patients’ needs rather than the physical context in deciding system use and design, with an emphasis on what is considered to be best practice. In the process towards patient-centred care it is important to remember that a generic solution might become an unsupportive tool for clinicians and undermine the purpose. The next step is to conduct a comparative analysis of ehealth development in Sweden and New Zealand.