McGrail, Zierler and Ip do an excellent job of analyzing the complex issues surrounding the value-for-money challenge in healthcare. In response to their call for a new perspective, the following observations are made. Many questions can be asked to help articulate values. More will be accomplished in the short and medium term by focusing on the simpler questions. Some questions about value will never have an absolute answer with complete agreement. Furthermore, what is valued in healthcare tends to be clouded by what is rewarded in healthcare. Although the authors call for reviving the notion of building a pan-Canadian health information strategy, there are excellent examples of provincial success stories on which to build (e.g., Ontario's Wait Times Information System). Research and evaluation will not add value unless they are closely linked to the knowledge needs of decision- and policy makers. In reply to the authors' call to stop treating information technology as optional and demand that anyone paid with public funds report on the use of those funds, it should be recognized that information technology is the enabler that everyone should use. What we need to stop treating as optional is accountability and appropriateness for the use of funds.
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