The traditional way for conceiving Health Information Systems (HIS) presents countless problems when tries to give support to local management orientated to health inequalities reduction. How can we design a local HIS and which would be its characteristics? We recognize the HIS as open and complex systems, and in which we are constituent part. The hypothesis says that a HIS that gives support to local management must be conceived as a set of processes constituted by data, information, knowledge, comunication and action (DIKCA). Data are a complex structure composed by five components: the analysis unit, the variable, the value of the variable, the indicator and the context unit. The information is a set of processed data (“an idea, a notion, a piece of news”); while in the production of knowledge exists comprehension and appropriation of the phenomenon by the subject. The communication is the axis that articulates the previous concepts with the action. The strategic actions (that is to say, orientated to su ccess) and the communicative actions (that is to say, orientated to understanding) must be considered as priority in local management. The logic of DIKCA dialectical process must not lose sight of its epigenesis. The evaluation included in this process should must give support to a second order reflection in the health workers. This proposal is oriented towards the support of management by the HIS in the elimination of health inequalities, and the construction of an inclusion society.