Enabling healthcare providers to access one set of patient records, wherever they are, should improve care—but can it work? In February 2002, the UK government decided that an unprecedented investment in information technology was essential to achieve its plans for the NHS in England. The decision bore fruit in an information technology programme that is the world's largest both in cost—some £18bn (€26bn; $32bn) over 10 years1—and, more importantly, in ambition. The NHS national programme for information technology is attempting to create the most comprehensive electronic health records infrastructure of any healthcare system, in which multimedia records compiled at the point of care are made available to authorised users in primary, secondary, tertiary, and community care. Ministers say the programme will connect 30 000 general practitioners and 270 acute, community, and mental health trusts to a single, secure, national system to make information available when and where it is needed, including to patients themselves.2 Four years on, this ambition is still far off. NHS Connecting for Health, the agency created last year to run the programme, admits that to date the programme has made little noticeable difference to clinicians and patients. However, it says that essential building blocks have been designed and procured, on unprecedented terms for the taxpayer, and that new systems are now being installed which will greatly improve healthcare practice. ![][1] Credit: IAN MCKINNELL/TAXI/GETTY This assessment is controversial. Informed criticism of the programme—leaving aside the populist view that any NHS investment in information technology is bound to be a disaster—falls into two strands. One, made most often inside the healthcare informatics community, is that the programme's central direction and political impetus has hindered rather than advanced progress. The second, made by some professional organisations and activist groups, says that the scale and proposed content of … [1]: /embed/graphic-1.gif