Many healthcare CIOs find themselves caught between technological imperatives and public policy on one hand and internal resistance to change on the other. Some healthcare CIOs who have undertaken massive, IT-driven transformation efforts are confronting serious challenges, from technological hurdles to their own staff's determination that patients, not processes, remain the foremost priority. What many institutions have created is a hodgepodge of healthcare IT (HIT) systems that partially automate their operations and processes without regard to the long-term benefits of these systems. Despite implementing mammoth electronic medical record (EMR) systems and building a host of advanced clinical systems, healthcare CIOs often have been dismayed to find that many of these projects fail completely or don't bring about the desired results.