Burgeoning efforts to improve health care quality and to wire the health care system provide the backdrop for this reflective commentary on expected and unexpected consequences of these twin revolutions. The author uses several case examples to illustrate how focusing on individual quality measures (eg, Pneumovax administration rates or timing of antibiotics) can distract providers from more relevant patient care issues. The author uses other examples to highlight the side effects of information technology, emphasizing that these innovations are tools, not solutions, to improve patient care and safety. The author advocates for better systems that not only provide improved patient outcomes but also support providers in their efforts to deliver safe, high-quality, and effective care. The author, who edits this site, also coauthored two past influential patient safety pieces, a book entitled Internal Bleeding, and an influential Agency for Healthcare and Research Quality (AHRQ)–supported evidence-based analysis of nearly 80 patient safety practices.