Everyone at The Queen's Medical Centre in Honolulu has their eye on some shiny new piece of technology. Doctors and nurses who have seen a new pharmacy management system demonstrated at a recent conference think the hospital should have it. An administrator wants his department to have PDAs to wirelessly access e-mail. Someone else wants a hospital-wide dietary management system — but doesn't have the budget to fund it.

And they want CIO and VP of IT Ken Kudla to get it all for them.

But before he even thinks about eking new systems out of his $US13 million annual operating budget, Kudla has to contend with the 30 projects he has going on right now. He's in the middle of upgrading the hospital's network and deploying an antispam management system. By mid-January, he's due to replace the seven different systems that make up his hospital information system. Meanwhile, he's trying to finish a document imaging project begun back in 2002, for which funding has been scarce. "CIOs are being bombarded," he says. "There's a pent-up demand for things."

Kudla isn't alone. Demand for IT is back with a vengeance. It's almost like the late 1990s. Except that what's missing now is the money, staff and late-night takeout to deal with today's demand. In turn, the requests for IT projects are piling up. CIOs say that managing this application backlog is the number-one barrier to their job effectiveness today, regardless of industry or company size.

How CIOs manage this burgeoning demand has a direct impact on whether business leaders view IT as responsive to their needs or not. "Any CIO who sets an expectation that something will get done — and it doesn't — will be committing career suicide," says Bob Holstein, CIO at National Public Radio. The challenge for CIOs, then, is to ensure that projects already in the queue are aligned with ever-changing business priorities, to manage business-side expectations and to control new sources of application demand from today's more sophisticated users. "One way you can interpret this [problem] is that users have a lot more appreciation of what's possible," says Holstein, "Or that the technology world has moved very quickly, and those business units want more, and they want it faster."

Whatever the source of the application backlog, CIOs should follow this cardinal rule: Don't complain. Nobody — especially your CEO — likes a whinger. "I tell my staff: You can't be a victim," says Susan Powers, CIO of Worldspan. "I don't accept the victim mentality."