Expectations for hospital information systems (HIS) have yet to be realized. Requirements have been defined by the International Medical Informatics Association, health care futurists, and others. With a volatile marketplace and evolving technologies, computerization has been a non-trivial task. However, recent advances in architecture and communication standards promise to make networking possible. In addition, the development of professional workstations and of computer-based patient records linked to new tools and applications can transform health care. For HIS to realize these expectations, however, technology assessment and outcome analysis must play critical roles.