In returning from the HIMSS 2012 Conference in Las Vegas - the premiere healthcare IT conference, I left with tired feet, over-stimulated sensory organs, and a feeling of overload. As a solutions integrator and a passionate client advocate, I am more than intrigued on the size and scope of the many exhibitors’ offerings and solutions. The messages being sent by the vendors tended to address operational, procedural, and efficiency gaps mainly from an IT focus. As a solutions provider, I understand the need for technology to address the gaps by healthcare organizations, however, I think the true questions and answers need to be addressed from the clinical side. The what, where, and how need to be asked from a clinical standpoint, and in that order. What are the true clinical issues that can be addressed by IT solutions, where is the right integration point for the solutions, and how do these solutions improve overall patient care? Moving the needle to improve patient care and improve care gaps is the ultimate goal of the healthcare system. Yes, revenue and efficiency are vital to success, however, it can’t be just a CFO and CIO targeted proposal. The CMOs and Clinical Directors need to be at the table to ensure the long-term viability of the integration, analytics, and data will provide the answer to improving clinical outcomes. Transformational solutions include predictive analytics, Vendor Neutral Archiving (VNA), data warehousing, business intelligence, and HIE to EMR bi-directional integration. Clinical solutions should be the driving force in the long-term planning of a healthcare organization’s roadmap when deploying IT solutions, not the traditional IT first or better said; avoid the tail-wagging-the-dog approach!