The National Health Service has embarked upon major initiatives to bring in management and financial information systems capable of relating resource usage to cost and to underpin better management and effective delivery of health care. This paper identifies a range of weaknesses and impending problem areas in implementation practice. Recent research evidence from several NHS regions is utilized to support the detailed case made for changes in how computer-based projects are developed, managed and implemented within the organization. It is suggested that the evidence and analysis would seem to have implications for all those studying, experiencing, or anticipating computerization.