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To achieve the full potential of information technology, health care institutions must overcome organizational and political barriers that often overshadow scientific and technical barriers. The time has come for an alliance between the Chief Information Officer (CIO) and medical informatics specialists, or informaticists. Organizations that successfully accomplish this alliance will position themselves to take advantage of the enormous potential of information technology to manage today's cost-quality pressures. This article first reviews some of the recent developments in the way health care organizations manage information technology. It then describes the traditional, perhaps the natural state of affairs, in which there may be tension and conflict between medical informaticists and line managers of information systems (IS). Finally, the article makes a case for closer collaboration and cooperation between these groups, and provides a case study that illustrates one example of such an alliance.