The scope and boldness of the National Health Service's Connecting for Health initiative are unprecedented. While nations worldwide have set health information technology as a high priority to combat medical errors and increase efficiency, England has outlined the most courageous goal of this kind, aiming towards a national electronic health record service. Implementing systems nationwide, or even regionally, is extremely difficult, yet England is making admirable progress and essential iterative adjustments. Ongoing evaluation efforts, such as those described in Hendy and colleagues' study in this week's BMJ,1 are necessary to guide such adjustments. Temporary setbacks are inevitable and we must learn from them.

Why is implementation of health information technology such a universally difficult process? It is because we are transforming health care through information technology rather than simply automating old …