Objectives To demonstrate and promote the importance of applying a scientific process to health IT design and implementation, and of basing this on research principles and techniques. Methods A review by international experts linked to the IMIA Working Group on Technology Assessment and Quality Development. Results Four approaches are presented, linking to the creation of national professional expectations, adherence to research-based standards, quality assurance approaches to ensure safety, and scientific measurement of impact. Conclusions Solely marketing- and aspiration-based approaches to health informatics applications are no longer ethical or acceptable when scientifically grounded evidence-based approaches are available and in use.