Health information technology (HIT) is widely viewed as a solution to improve the quality and safety of care, but past studies have pointed out the unintended consequences of adoption. This study provides a detailed cost and benefit analysis of investment in HIT based on experiences in the Department of Veterans Affairs. The authors estimate the potential value (benefits net of investment costs) of these investments at more than $3 billion and provide a framework for determining such value in the private sector. Their discussion, including the limitations of applying the VA system learnings more broadly, is timely given the current federal stimulus dollars being dedicated to investments in HIT.