Hospitals' historically lackluster IT spending continues through 2009, with the recurring themes of low outsourcing, tight budgets, and focus on operational stability over innovation. But after years of waiting for widespread adoption of electronic health records (EHRs), the US government's injection of $36 billion in incentives may finally move the needle. Sales teams will need to be ready to manage those two worlds — a desire to jump on the EHR bandwagon and a culture of IT as a utility — if they are going to successfully win their share of this soon-to-pop market segment.