Today it is a general belief that e-health has a positive effect on costs as well as on quality of health service delivery. Nevertheless, lots of projects failed in the past to clearly demonstrate a positive value proposition. Difficulties arise especially when not only evaluating a single action but a whole strategy for adopting national or provincial e-health. Grounding on the experience of an ex ante evaluation of the Swiss e-health strategy, a first attempt how to practically demonstrate the value of the planned health system’s changes is discussed in this article. On the basis of a “utility” and a “readiness” portfolio, generic allocation decisions are formulated for prioritising investments as well as for identifying weak points in the defined e-health strategy.