Tonya Edwards, MD/MMM, Senior Physician Executive, and Joan Campbell, RN, Clinical Informaticist, Impact Advisors. Dr. Edwards and Joan discuss management of the tidal wave of changes necessary to be successful as health systems transition to value-based payment environments. They also cover developing true systems out of federated states to reduce clinical variation and cost, integration of IT into every operational area, development of robust governance for care delivery decision-making and IT enablement of care and development of request prioritization methods owned by operations. Additionally, they discuss proven techniques for leaders to manage change, making order out of chaos.