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Information technologies have become essential components in health care organizations given their potential for enabling better quality of care, improving productivity and efficiency, and supporting new approaches for patient management. Subsequently, IT executives are facing a dynamic and demanding environment that present new issues, challenges, and opportunities. This study aims at gaining a better understanding of the key IT management issues facing IT executives over the next three years. We address this question by conducting a Delphi survey among 30 CIOs / IT directors in Canadian hospitals. Three simultaneous surveys were conducted in different settings: rural / small, community, and academic hospitals. The results demonstrate considerable similarities in the issues identified by the three panels. The most critical issues included managing demands and expectations for IT services, having sufficient funds, recognizing IT as a key stakeholder in major decisions, implementing EHR, and aligning strategy across hospitals, heath networks and the province. We conclude by discussing implications of our preliminary findings for both research and practice.