By CereCore Media Coverage | Aug 15, 2025
6 minute read Technology| CereCore News| IT Strategy
This article was originally published in the August/September HFM Issue Magazine by Peyman Zand, CSO.
A 2025 survey of health IT executives offers insights healthcare CFOs can use to better collaborate with their CIO colleagues.
Hospitals and health systems face mounting challenges today in managing IT cost and strategy. While responsibility for guiding their organizations through these challenges invariably falls to the CIO, finance leaders also have a critical role to play in this effort as partners with IT leaders — and often from a position of providing oversight of the IT function.
A March 2025, year-over-year survey of 46 healthcare IT executives who are members of the College of Healthcare Information Management Executives (CHIME) sought to obtain insight into their current top priorities and the key pressures they are facing today. Findings of the survey underscore areas where a CIO can benefit from a collaborative partnership with the CFO.
Such collaboration is critical given that health IT inefficiencies can quietly drain millions from hospital budgets and put patient care at risk. Many of these inefficiencies are byproducts of COVID-19, when IT was confronted with a strategic need to focus on speed, enabling telehealth and remote work.
Insights from the March study show that attention has shifted to sustainability and cost control, with a focus on four areas in particular:
By understanding the strategic concerns and challenges CIOs face in addressing these areas, CFOs can better collaborate with their IT colleagues and be informed partners in developing more effective IT budgets for the future.
Unplanned technical debt is increasingly recognized as a top barrier to progress for health systems. The term technical debt refers to the consequence of costs and inefficiencies that health systems may incur when they prioritize short-term IT solutions to obtain fast results instead of pursuing broader and more sustainable long-term solutions.
The COVID experience was a breeding ground for such short-term solutions. The build-up of costs and inefficiencies from these temporary fixes has posed a barrier to health systems’ more measured adoption of efficient and comprehensive IT solutions.
Moreover, the survey results suggest that the barrier has grown. Fully 29% of the survey respondents said their concern about technical debt has increased compared with previous years. These costs show up in delayed innovation, frequent downtime and rising support needs.
In many organizations, these issues worsen when IT teams must manage a mix of outdated systems and tools that no longer align with current goals.
CIOs pointed to three primary areas where technical debt consumes the bulk of the IT budget:
Further, IT leaders said hidden inefficiencies, not large purchases, often create the biggest drain. Fragmented tools, poor integration and manual workflows raise costs and slow progress toward immediate and forward-thinking digital health goals.
Budget challenges are particularly severe for hospitals with fewer than 250 beds. Leaders from these hospitals are increasingly concerned about technical debt, with 41% reporting it as a growing issue that can hinder progress if not addressed. The survey found that cost-cutting efforts by these hospitals have included consolidating managed IT service providers and “as needed” access to support to manage essential operations with lean teams. Because these organizations operate with limited internal resources, every technology investment must provide clear value.
The CFO’s role. The finance leader should take an active role in maximizing the strategic value of technology. Their responsibilities should go beyond budget oversight to include evaluating the long-term costs of short-term IT decisions. By factoring technical debt into financial plans, the CFO can help identify future liabilities hidden in temporary fixes.
In collaboration with the CIO, the CFO also should lead IT-asset lifecycle planning and advocate for dedicated budgets to refresh aging systems. This charge includes evaluating opportunities to consolidate vendors, which can lower costs and simplify operations.
Financial teams are essential for supporting strong business cases for IT investments that focus on total return, not just initial costs. These cases should consider operational efficiency, system reliability and the capacity to scale over time.
The need for remote access and hybrid work models, where teams split time between onsite and remote work, continue to stretch support teams thin. At the same time, finding and retaining skilled talent remains a top concern for CIOs. The following percentages of CIO survey respondents cited four roles as the hardest to fill:
With demand outpacing available talent, health systems are rethinking how they staff IT. Rather than let critical roles go unfilled, leaders are turning to flexible strategies to meet operational needs and avoid burnout. CIO survey respondents identified the following strategies for staying ahead on niche projects or larger components of their IT operations:
The CFO’s role. The finance leader should work closely with the CIO to develop flexible talent strategies that align with budget constraints and address workforce shortages. Together, they should perform a clear cost-benefit analysis of external contractors versus internal staff, especially for specialized roles.
Long-term workforce plans should anticipate IT talent needs 12 to 24 months in advance to build a sustainable pipeline. It is critical that vendor and contract labor agreements include defined performance metrics and cost-control measures to protect the organization’s investment and enforce accountability.
Constantly faced with hidden IT team inefficiencies, CIOs are pursuing strategies to simplify and consolidate processes to improve efficiency. Objectives include simplifying infrastructure, consolidating the number of IT outsourcing partners and aligning technology investments with clinical workflows. These steps help control costs while supporting long-term goals. Among CIO survey respondents, 55% say one of their top strategies is to establish a road map for refreshing technical capabilities and maintaining their lifecycle, underscoring the need for clear, proactive planning to prevent inefficiencies.
The CFO’s role. Finance should play a central role in driving operational efficiency through technology. CFO responsibilities include backing investments in automation and consolidation tools that eliminate redundant processes and reduce manual effort. The finance leader also should partner on multi-year infrastructure plans that directly link technology costs to performance outcomes.
A key CFO responsibility is to provide transparency about the full costs of inefficiency, which go beyond direct expenses to include indirect effects such as clinician frustration or decreased patient throughput. To measure progress, the finance leader should advocate for standardized vendor scorecards. These tools help quantify and track efficiency improvements over time and ensure the expected value from technology investments is realized.
Many larger hospitals are now evaluating and implementing AI in areas such as sepsis detection and operational analytics. In fact, 24% of CIO survey respondents at hospitals with more than 250 beds identified AI as their top priority driving cost savings and efficiency. Some CIOs reported success in specific use cases, including revenue cycle automation, virtual nursing assistants and clinical documentation support.
Nonetheless, the survey participants tended to agree that AI should not be implemented if the organization has not first established a simplified, stable IT infrastructure. This caution is evident when one considers the survey responses of all participating CIOs, with only 14% identifying AI as a current top priority.
While interest is growing, most leaders are moving carefully. Many are hesitating to adopt AI before fixing system-level issues that create complexity and waste. They perceive that without a stable infrastructure, new AI tools risk compounding existing problems, and that pushing forward too quickly could lead to higher costs and lower returns.
Yet organizations that move too slowly risk falling behind. A better strategy for the CIO is to collaborate with the CFO on developing clear guidelines for AI adoption now by actively exploring where AI can deliver meaningful operational improvements.
The CFO’s role. The governance of a health system’s approach to AI requires direct leadership from the finance department. It is incumbent on the CFO to champion a comprehensive AI framework that addresses cost, ethics, risk, long-term sustainability and appropriate-use policies. Financial oversight of AI pilot evaluations also is needed to ensure that key performance indicators and ROI thresholds are established upfront.
In addition to these efforts, a three-way collaboration among finance, IT and operational teams is imperative to identify low-risk, highvalue AI use cases, such as in revenue cycle management or documentation. This strategic approach, with financial guidance, ensures AI investments align with the broader digital strategy and address core problems instead of merely automating existing inefficiencies.
Source: March 2025 survey of CHIME members
In the face of the foregoing challenges, health systems require focused strategies to reduce waste, ease support burdens and help IT teams focus on long-term goals instead of short-term fixes. Finance leaders have a pivotal role to play in ensuring these IT investments support both clinical and operational goals.
Along with the collaborative steps described here, a strong first step in the finance-IT collaboration is to lay the foundation for all future work by conducting a full inventory of current IT spend. The CFO and CIO should undertake this step with an eye toward reducing support ticket volume, improving system uptime and eliminating manual tasks or duplicate tools. This effort also will provide the leaders with a basis for identifying opportunities for future investments that will boost IT efficiency.
This collaboration will be especially important in guiding the organization’s future digital transformation. CFOs can play a pivotal role in evaluating long-term costs versus short-term gains by helping to assess where innovative technology delivers measurable ROI and improves organizational productivity for both business and clinical teams. The CFO’s role should be to reinforce the idea that the ability to make smart IT buying decisions hinges on leaders’ understanding of the total cost of ownership for each system — including direct costs, ongoing maintenance and the impact on staff time and productivity.
In short, both the CIO and the CFO should operate from the guiding principle that strategic IT investments do more than fix today’s problems; they protect revenue and open the door for future innovation.
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