Health information technology presents major challenges as well as opportunities in creating care that fulfills the Institute of Medicine's aims of being safe, timely, effective, efficient, equitable, and patient-centered. This commentary examines the barriers that relate directly to the collection and use of information in practice, and it explores some of the possible solutions. Only through concerted efforts involving major changes in the way we collect, store, analyze, and use information related to the care of patients with cancer, paired with active practice redesign and reimbursement reform, are we likely to achieve the substantial progress envisioned by Paul Wallace.