For the healthcare industry to move forward and achieve the goals set out in the Health Information Technology for Economic and Clinical Health Act, as well as similar initiatives outside the US, the cloud must play a major role in the next generation of healthcare IT. In order for cloud-based solutions to be used economically and effectively they need to provide significant ROI. Cloud Services Brokerage (CSB) has the potential to address these cloud governance challenges and more, while addressing many concerns that hinder cloud adoption.