Despite the considerable progress that’s been made to bridge the gap between IT and radiology, in part through the development of sophisticated IT-based radiology practice solutions, a considerable understanding gap remains between those who implement and support solutions and those who use them. According to results from a recent survey conducted by Adam H. Kaye, MD, MBA, of the Hospital of the University of Pennsylvania, and presented at the 2014 annual meeting of the Society of Imaging Informatics in Medicine (SIIM), individuals from IT and radiology staff working in the same facility feel like fish out of water when asked about the specific day-to-day workflows and decision-making processes of the other group. After completing a survey and participating in a shadowing experiment, the two groups gained alignment, achieved only because they were able to experience and understand the needs of the other group and recognize the importance of communication.