Integrated delivery systems (IDSs) recently have invested substantial financial resources in information technology (IT) initiatives. But the return on that investment for many IDSs in terms of improved productivity and reduced costs has been less than anticipated. Therefore, to improve or enhance the success of IT initiatives, some IDSs have sought to encourage more physician support of such efforts by creating a new executive position--director of medical informatics--designed to be filled by physician leaders who have knowledge and skill in managing information systems. The director of medical informatics, who typically reports to the CEO or CIO, coordinates IT initiatives that address physician concerns and promotes physician buy-in.