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The levels of resistance to a new informatics system can vary widely both between and among specific groups. The relevance to today's behavioral medicine area is obvious. The aim of effective change management techniques is not to eliminate all resistance. This is typically impossible when a group of any size is involved. The aims are (1) to keep initial general resistance at reasonable levels, (2) to pre-vent that initial resistance from growing to serious levels, and (3) to identify and deal with any pockets of serious resistance that do occur despite the previous efforts. His article outlines areas of resistance to behavioral informatics and offers suggestions for overcoming the resistance.

As increasingly powerful informatics systems are designed, developed, and implemented, they inevitably affect larger, more heterogeneous groups of people and more organizational areas. In turn, the major challenges to system success are often more behavioral than technical. Successfully introducing such systems into complex health care organizations requires an effective blend of good technical and good organizational skills. People who have low psychological ownership in a system and who vigorously resist its implementation can bring a "technically best" system to its knees. However, effective leadership can sharply reduce the behavioral resistance to change-including to new technologies-to achieve a more rapid and productive introduction of informatics technology. This paper looks at four major areas-why information system failures occur, the core theories supporting change management, the practical applications of change management, and the change management efforts in informatics.

What are the keys to implementing a new information system within a physician environment? How can resistance to the technology be circumvented? Should physicians be brought in on the front end of system development, to help design information technology that can meet their needs? The authors give some timely advice for the information-driven industry.

The University of Cincinnati Medical Center has combined five existing units into a new organization responsible for initiating an Integrated Academic Information Management System (IAIMS). This new organization, Medical Center Information and Communications, was reorganized into nine departments, which now provide a variety of information services. Ultimate goals for IAIMS include a patient-centered database, a decision-support system, and a knowledge network. The IAIMS prototype, currently under development for the University of Cincinnati Hospital's Internal Medicine Service, consists of components representative of the IAIMS model's ultimate goals. A major premise of this IAIMS effort is that it is patient-centered.