This paper discusses critical success factors (CSF) and best practice in relation to IT implementation in the health sector. We have studied a University Hospital’s implementation of a health information system (HIS) and particularly one clinic which implementation process was described as very successful compared to other units at this hospital. The purpose of the paper is to gain further understanding of if and how well CSFs and best practice solutions can explain this successful case. We do this in order to explore if CSFs and best practice offer any shortcuts to successful IT implementation. By understanding the reasons behind this case’s success we can identify if CSFs and best practice potentially can explain the success, or if there are other explanations in this case. Based on our findings we discuss and question the sometimes overestimated belief in CSFs and best practice as shortcuts to success performance. An important contribution from this study is that situational and contextual factors are very critical to understand and acknowledge during HIS implementations.