The Geisinger Institute for Advanced Application (IAA) leverages specialized IT infrastructure to accelerate IT and development related needs. This resource continues to reflect an important cultural shift at Geisinger Health System and facilitates inter-institutional collaborations around novel translational approaches to re-engineer how healthcare is delivered. The specialized infrastructure ensures system-level data security, while providing the flexibility needed by staff and patients to explore the use of novel IT solutions in healthcare. We also engage small populations so that agile methodologies for real-time testing occur in clinical care settings. The specialized environment is updated on a regular basis to ensure that applications are tested/run on the most up-to-date versions. Geisinger IT and administration have developed administrative procedures for contracting with software developers and for reviewing specifications of software development and implementation. This specialized environment has dramatically expanded opportunities for experimenting with newly created software tools.