Policy makers would do well to read Glasziou and colleagues’ excellent article on pay for performance as an object lesson in how to analyse the potential costs of change before committing to targets.1 Two recently published policy documents make extravagant claims for the savings to be made by adopting apparently mundane IT solutions in the NHS. The Department of Health report “The Power of Information” forecasts total savings of £2.865bn ($4.56bn; €3.6bn) from a revitalised NHS information strategy, of which £2.43bn is saved by giving patients direct access to medical records.2 A report by management consultants Transform, entitled “Digital by Default: the Delivery Choice for England’s Population,” proposes £2.9bn of savings from 10 so called easy wins, including £1.1bn savings by sending negative test results to patients by text message.3 All of these figures can be challenged.

Aside from potential double counting, digging behind these headline figures is revealing. “The Power of Information” provides financial spreadsheets that purport to give the evidence behind the claims.4 The £2.43bn saving is …