A functional information technology ecosystem is an important aspect of establishing and maintaining a successful point-of-care ultrasound (POCUS) program. Physicians who utilize ultrasound should have a basic understanding of how cart-based and handheld ultrasound machines interact with and integrate into the healthcare system’s imaging infrastructure. This includes an appreciation of the core functions of a cart-based machine, as well as the unique challenges that occur when handheld devices are integrated into the imaging infrastructure. Physicians with advanced training in clinical ultrasound should be able to identify and work with key collaborators within the information technology domain to acquire all necessary equipment and software needed to create and maintain a POCUS program. This includes acquiring the necessary ultrasound equipment, ancillary hardware, and workflow software to accurately identify patients, archive ultrasound images to a long-term storage network, and link imaging reports within the electronic health record.