Health care is witnessing a rapid adoption of health information technology. While this transformation is generally good news, it has been characterized by many unintended, and unexpected, consequences. This presentation will discuss why implementation of health IT requires “Requisite imagination”, which is the "ability to imagine key aspects of the future we are planning" and foresee potential traps. The presentation will discuss a sociotechnical approach to implementation, one that involves continuous assessment and improvement in a complex adaptive health care system. Health IT implementation is a never-ending task, and in addition to scientific rigor, it requires foresight, measurement, commitment, resources, and shared responsibility.