Healthcare’s technology priorities are being rewritten by cost. From rural hospitals to major academic medical centers, leaders nationwide are confronting the same pressures — rising labor costs, reimbursement compression, regulatory complexity and the escalating expense of scaling AI beyond pilots. The result is a clear shift in how investments get evaluated: Novelty alone no longer earns a place on the roadmap.
Becker’s asked health system leaders which cost pressures are reshaping their technology strategies, and the answers point to a field moving from experimentation toward discipline. Ambient documentation tools are proving their value by easing clinician burden, while revenue cycle automation and denial prevention are absorbing investment as reimbursement tightens. Meanwhile, leaders are consolidating vendors and demanding measurable ROI before committing capital, especially as unpredictable AI pricing makes costs harder to forecast. Below, 40 executives share what’s defining their roadmaps.
The leaders featured here are speaking at Becker’s 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, set for Sept. 14-17 at the Hilton Chicago.
If you would like to join the event as a speaker, please contact Scott King at sking@beckershealthcare.com.
As part of an ongoing series, Becker’s is connecting with healthcare leaders who will speak at the event to get their perspectives on key issues in the industry.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Which cost pressures are reshaping your tech roadmap?
Pradeep Singanallur. Vice President and Enterprise Chief Medical Officer for Centra (Lynchburg, Va.): Our cost pressures are pushing our tech roadmap to be much more focused on tools that improve quality, throughput, margin, and the clinician experience. The biggest areas for us are labor expense, denials, length of stay, observation management, documentation gaps, ED flow, and reducing the noise from fragmented vendor solutions. We are trying to be thoughtful about using AI, analytics, CDI/physician advisor workflows, and operational dashboards in a way that helps teams make better decisions earlier and supports better outcomes for our patients. Ultimately, our goal is not just more technology, but technology that helps us deliver higher-quality care more reliably, while also making the system more sustainable.
Joe Diver. Vice President and Chief Information Officer for Signature Healthcare Brockton Hospital School of Nursing (Brockton, Mass.): Healthcare organizations are facing significant financial pressure from rising labor costs, reimbursement challenges, and increasing demand for digital services. As a result, our technology roadmap is increasingly focused on initiatives that improve operational efficiency, reduce administrative burden, and help clinicians spend more time with patients. We’re prioritizing investments that streamline workflows, automate manual processes, improve revenue cycle performance, and support workforce productivity across both clinical and non-clinical areas.
At the same time, patients and providers expect a more seamless digital experience, which requires continued investment in patient engagement tools, interoperability, self-service capabilities, and thoughtfully deployed AI solutions. Given limited resources, every technology investment must demonstrate measurable value whether through improved patient access, enhanced care delivery, increased staff efficiency, or stronger financial performance. The focus has shifted from pursuing the newest technology to investing in solutions that solve meaningful business and patient care challenges.
Tinu Tadese, MD. System Chief Medical Informatics Officer for Boston Medical Center (Mass.): As a physician leader in a safety-net health system, I view every technology investment through three lenses: patient care, clinician impact, and responsible stewardship. Every technology investment is ultimately a patient care decision, a clinician workflow decision, and a stewardship decision.
That reality has fundamentally changed how we evaluate investments. We’re looking for technologies that remove friction, reduce administrative burden, automate repetitive work, and give physicians, nurses, and care teams more time to care for patients. At the same time, every investment has to strengthen operations, improve quality, and help us standardize and scale across an increasingly integrated health system.
Our patients deserve access to the best care we can provide. Our clinicians deserve technology that works for them—not around them. And our communities deserve the confidence that we’re using every dollar entrusted to us wisely. That’s the lens through which we build our technology roadmap.
Dennis Leber, PhD. Chief Information Security Officer for Erlanger Health System (Chattanooga, Tenn.): Rising labor costs, vendor spend, and regulatory burden are fundamentally reshaping our technology roadmap. We’re aggressively consolidating our security and infrastructure stack — prioritizing platform-based solutions, particularly within Microsoft, to reduce duplication, licensing, and operational overhead.
At the same time, we’re shifting investments toward automation, AI-enabled workflows, and identity-centric security to drive efficiency and reduce reliance on manual processes. Ultimately, every technology decision now has to demonstrate measurable risk reduction and cost optimization, not just capability.
Sheri Strobel, MSHI, CPA. Chief Information Officer for Chapters Health System (Temple Terrace, Fla.): The biggest cost pressure reshaping our technology roadmap is that healthcare cannot cut its way into the future. We must redesign how work gets done, and that means treating AI as a capacity strategy, not a tech experiment.
For us, that means prioritizing simplification, automation, and strategic AI investments that can reduce administrative burden, improve revenue cycle performance, help clinicians spend more time in care, and give leaders better insight from the data we already have.
The opportunity is real, but the bar must be higher than pilots; AI has to be governed, embedded into workflows, and measured by whether it improves the experience for patients, families, caregivers, and the organization.
Cheyenne Holland. Chief Financial Officer for Gifford Health Care (Randolph, Vt.): Labor costs continue to put a lot of pressure on our organization, both clinical and non-clinical staff. Our tech roadmap is focused on adding technology and tools to augment staff effort. Technology doesn’t replace the need for humans, but our philosophy is to utilize technology for repetitive, transactional tasks to allow staff to focus on high value work.
Chaitanya Vempati. Associate Vice President, AI and Analytics for Memorial Hermann Health System (Houston): Thinking tokens and compute costs are quickly becoming the biggest line items to track in agentic workflows, especially as the era of flat-rate and heavily discounted pricing comes to an end. The most effective approach we’ve found is treating ROI monitoring as a structured, ongoing discipline rather than a one-time evaluation – tracking cost per outcome, not just cost per call. At Memorial Hermann, we’ve also seen real value in building internal skill sets to identify inefficient workflow design and optimize it, which often delivers more savings than pricing negotiations alone.
Brian Lancaster. Senior Vice President and Chief Information Officer for Children’s Mercy (Kansas City, Mo.): Cost pressures are always present in healthcare. The pressures on my roadmap are really centered on the value proposition of the technology within it. In other words, what are we doing to make the enterprise more efficient, and what are the benefits of doing so? Understanding this leads to support for investment in technology, as it helps drive benefits in patient care and research.
For example, I was able to gain support for an enterprise rollout of ambient AI due to the demonstrated benefits of that technology on the patient and provider experience. We have seen meaningful improvements in documentation efficiency, reduced administrative burden on clinicians, and more time for direct patient interaction, all of which contribute to better patient experience and reduced provider burnout. If I had focused only on the cost of providing it to all physicians and APPs, I would not have been able to get it onto our roadmap.
Bob Berbeco. Chief Information Officer for Mahaska Health (Oskaloosa, Iowa): Cost pressures are forcing us to be more disciplined about every technology decision, especially in a rural health system where supportability and long-term value matter as much as innovation. As a result, our roadmap is increasingly focused on workflow-native capabilities that reduce waste, such as ambient documentation and denial forecasting, while continuing to strengthen foundational investments like data governance, analytics, identity, and cybersecurity. It also means being much more selective about bolt-on tools unless they provide clear incremental value beyond what we can achieve through our core Epic and Community Connect strategy.
Darlynn Tate, MBA. Director, Revenue Cycle and Coding for Columbia University Irving Medical Center (New York City): Rising labor costs, reimbursement pressures, and increasing administrative complexity are driving our technology roadmap. While automation, AI-driven analytics, and workflow optimization remain key investment areas, we’ve learned that technology alone doesn’t create value. Success depends on thoughtful change management, stakeholder engagement, and ensuring new tools are seamlessly integrated into existing clinical and operational workflows. As we continue to enhance Epic automation and deploy upstream revenue cycle edits, our focus is equally on adoption and process redesign as it is on the technology itself.
David L. Reich, MD. Chief Clinical Officer for Mount Sinai Health System; President for The Mount Sinai Hospital (New York City): As a mission-driven academic health system, the technology capital budgeting process is challenging in an era where health systems have slim margins. We must balance our commitments to leading in the responsible uses of AI and digital innovation against the costs of maintaining robust cybersecurity, infrastructure, judicious use of vendors, and all of the competing investment priorities for a large health system. We prioritize based on value on investment (VOI), which can be financial ROI coupled with improvements in KPIs linked to safety (e.g., mortality reduction) or optimization of patient and staff experiences.
Pallavi Yadav, MBBS, MHA. Director of Quality Improvement and Patient Safety, The University of Toledo Medical Center (Ohio): Cost pressures today are coming from multiple directions: rising costs and the growing financial risk tied to value-based care. Because of that, our tech roadmap is focused on optimization: by improving EHR efficiency, strengthening interoperability, and using automation to ease manual work and improve quality indicators such as reducing length of stay. We’re also intentional about applying Lean Six Sigma principles to eliminate waste and improve efficiency, while investing in our people so they can perform at their highest level through structured performance improvement training and high reliability practices. Ultimately, our goal is to capture the full value of care through strong documentation, real-time insights, and alignment with value-based incentives.
JohnRich Levine, DNP, DPA. Chief Nursing Officer for Reeves Regional Health (Pecos, Texas): The biggest cost pressures reshaping our technology roadmap are workforce shortages, rising operating expenses, and the need to do more with limited resources. As a rural hospital serving a large geographic region, we evaluate technology through a simple lens: Does it improve patient access, support our caregivers, and strengthen operational efficiency? We are prioritizing solutions that reduce administrative burden, enhance clinical decision-making, and extend the reach of our workforce. In rural healthcare, the challenge is not adopting technology—it is adopting technology that delivers measurable value and remains sustainable in the long term.
Nabil Chehade, MD. Senior Executive Vice President and Chief Clinical Transformation, Innovation and Strategy Officer for MetroHealth System (Cleveland): Cost Pressures Reshaping the Tech Roadmap
Two major cost pressures are forcing a more disciplined approach to technology investment:
- Rising unreimbursed care: The growth of unsustainable charity care is reducing the dollars available for core technology initiatives, requiring much tighter prioritization of where we invest.
- Accelerating AI and software demands: At the same time, AI capabilities and related software are evolving rapidly and are increasingly viewed as must-have investments, even when the return on investment is uneven or not yet clearly defined.
Together, these pressures are reshaping the roadmap by narrowing the focus to the highest-value technology investments while increasing the need for rigorous evaluation of cost, impact, and strategic alignment.
Penny Jefferson, RN. Director of Clinical Documentation Integrity Services, HIM Division, Patient Financial Services for UC Davis Medical Center (Sacramento, Calif.): At our facility, the cost pressures most directly reshaping our technology roadmap are labor constraints, denial prevention, and the increasing regulatory burden tied to documentation accuracy. We are prioritizing technology that helps teams work more efficiently in real time, strengthens medical necessity and regulatory documentation before the claim is submitted, and reduces preventable rework across CDI, utilization review, coding, and revenue cycle. The goal is not simply automation for efficiency, but technology that supports compliant, defensible documentation while protecting reimbursement and reducing avoidable administrative costs.
Austin Palmer, MHA, CHFP. Chief Financial Officer for Arkansas Valley Regional Medical Center (La Junta, Colo.): Our technology roadmap is increasingly being driven by financial sustainability rather than innovation alone. Keeping pace with rapidly evolving healthcare technology while operating on legacy EMR platforms presents a significant challenge, as the capital required for modernization often exceeds what rural hospitals can reasonably absorb. At the same time, the prospect of Medicaid funding reductions creates real and immediate uncertainty, forcing us to prioritize essential infrastructure investments over transformational initiatives. The lack of clearly defined Rural Transformation Program (RTP) criteria and guidance further complicates long-term planning, making it difficult to confidently invest in technologies that support quality, efficiency, and patient access while ensuring the organization remains financially sustainable.
Stephen B. Williams, MD. Associate Chief Medical Officer for UTMB Clear Lake; Medical Director for High Value Care, UTMB Health System (Galveston, Texas): The greatest cost pressures reshaping our technology roadmap are workforce shortages, administrative burden, and the growing expectation to deliver higher-quality care with finite resources. As healthcare organizations face increasing financial constraints, technology investments must demonstrate measurable operational value—not simply add another layer of complexity.
Our focus is increasingly on AI-enabled solutions that improve clinical throughput, reduce unnecessary utilization, automate administrative work, and support more timely care decisions. Areas such as prior authorization automation, clinical documentation support, patient navigation, predictive analytics, and care coordination offer significant opportunities to improve both efficiency and the patient experience.
Ultimately, the organizations that will succeed are those that move beyond technology adoption alone and deploy digital solutions that simultaneously improve quality, access, workforce sustainability, and financial performance. Every technology investment should answer a simple question: does it make care better, easier, faster, or more affordable for patients and clinicians?
Sandra Lood. Vice President of Revenue Cycle Management for Cottage Health (Santa Barbara, Calif.): Labor costs and turnover are the biggest pressures, so we’re prioritizing automation that removes manual work especially in transactional areas such as eligibility, denials, and coding. Additionally, margin compression is forcing us to be far more disciplined about ROI, leading to consolidating vendors and investing in platforms that drive end-to-end visibility. We’re also responding to rising denial rates and payer complexity by doubling down on AI-driven analytics and workflow optimization. Finally, patient expectations around transparency are pushing us to invest in upfront estimates and digital financial engagement to shift collections earlier and reduce downstream cost, while elevating our patient experiences with our system.
Omar Sangurima, DIT. Head of Program Management and Cyber Third-Party Risk for Memorial Sloan Kettering Cancer Center (New York City): The cost pressure reshaping my roadmap is a hidden one: the unpriced risk sitting inside every security decision a health system delays. Most organizations treat cybersecurity governance as a cost center and a brake on the clinical mission, so the real expense never lands on a budget; it surfaces instead as stalled initiatives and slow vendor decisions that pile up while no one quantifies what the delay actually buys. The shift that matters is learning to price risk in business-impact terms, so leadership can weigh a security trade-off the same way it weighs any capital investment. Once risk has a number, security stops being the thing that slows medicine down and becomes the thing that lets it move faster.
Babatope Fatuyi, MD. Chief Medical Information Officer for UTHealth Houston (Houston): The dominant cost pressure reshaping our roadmap isn’t budget, its capacity. The human bandwidth required to implement and sustain technology has become the real constraint, with Epic optimization, integrations, reporting, and revenue cycle analytics all competing for the same finite time from analysts, informatics, and clinical leadership. So, we’re prioritizing automation of routine workflows, scalable governance, and high-impact EHR optimization, concentrating scarce technical capacity on work that directly improves access, quality, revenue cycle performance, and clinician efficiency. The projects that rise to the top are those that reduce friction for clinicians, protect revenue, or eliminate avoidable manual work, not technical novelty for its own sake.
Lisa Stump, BSPharm. Executive Vice President and Chief Digital Information Officer for Mount Sinai Health System (New York City): The biggest pressure on our tech roadmap is the cost of scaling AI from pilots to enterprise capability. The real investment isn’t just in models or individual vendor solutions — it’s in the data, governance, integration, and workflow redesign needed to make AI safe, reliable, and impactful. That means making sharper choices on platforms over point solutions and aligning with strong partners, so we prioritize use cases that create real value — through financial returns, better outcomes, higher throughput, or reduced administrative burden. Delivering and documenting that value is critical to the success of our enterprise.
Patsy Gallian. Pharmacy Revenue Cycle Director for Boston Medical Center (Boston): Our technology roadmap is being reshaped by a combination of intensifying cost pressures and the strategic need to strengthen our revenue cycle processes. Revenue cycle is evolving rapidly, so it is imperative that we pivot with these changes. This requires a strategic balance because, as a disproportionate‑share hospital, we operate with structurally thin margins — meaning for every technology decision we must weigh short‑term affordability against long‑term financial resilience. This means we must be disciplined in managing today’s financial strain while still investing in the systems, people, and processes that protect our future revenue performance.
Richard Zane, MD. Chief Medical and Innovation Officer for UCHealth (Aurora, Colo.): We’ve always treated our technology capital as a precious resource and fundamentally believe that healthcare cannot be the last bastion of industry where deploying technology increases cost and complexity. Our value proposition rubric is relatively simple for when we consider tech deployment; will the technology allow us to do more or better for the same cost or the same for lower cost. Cost, more and better mean different things depending on the technology and the problem statement but the charge is unambiguous.
George T. “Buddy” Hickman, C-DHE, CHCIO. Chief Digital and Information Officer for Roswell Park Comprehensive Cancer Center (Buffalo, N.Y.): The factors today are many and at increasing vectors: Margin pressure from all sides, payer efforts to diminish reimbursements and specific program enrollments, decreases in cancer research funding, global impacts on supply chain costs including technology, vendor movement to transaction based costing model, maintaining competitive wage rates, increasing benefits and pension funding costs, and the necessity to invest in cyber assurances. Did I leave anything out?
Mackenzie Schild. Vice President of Data and IT Project Management, Centerstone (Nashville, Tenn.): I wouldn’t necessarily say “pressures” are shaping the roadmap as much as being cautious around variable cost-based AI products and usage. That is probably going to have the largest impact that I see from a cost perspective and will require a close lens of AI sustainability to ensure that we’re capitalizing on our credit usage and resurfacing previously mined insights without necessarily taxing additional CPU.
Tony Sillemon, PsyD, MSW. Director, Community Health for Alta Bates Summit Medical Center, Sutter Health (Berkeley, Calif.): The biggest cost pressures reshaping our tech roadmap are workforce constraints, rising labor costs, medication and specialty pharmacy expenses, and the growing need to do more with limited operational resources. For community-based programs like ours, technology has to help reduce administrative burden, improve access, and support care teams without creating additional complexity. We are prioritizing tools that strengthen care coordination, improve data visibility, streamline revenue cycle workflows, and help identify patients who may be at risk of falling out of care. The goal is not just cost containment, but using technology strategically to improve outcomes, sustain access, and support the teams delivering care.
Ryan Kenney. Vice President, Strategy Enablement for Nebraska Medicine (Omaha): The technology roadmap is increasingly being dictated by the economics of healthcare. Labor costs remain our largest expense category, and we anticipate continued labor inflation. Additionally, reimbursement compression, cybersecurity risk, and rising consumer expectations are forcing us to prioritize technologies that either create capacity, extend our existing staff by removing administrative work off their plates, reduce cost-to-serve, or generate new revenue. In an academic medical center with strained margin, every major technology investment must have a clear impact on one of those outcomes.
Courtney McNamee. Director of Revenue Cycle and Reimbursement for Altru Health System (Grand Forks, N.D.): Labor cost pressure and workforce shortage are fundamentally reshaping the revenue cycle technology roadmap, accelerating investment in automation and AI to reduce manual work and enable scalable work by exception models. At the same time, sustained margin compression is forcing much tighter discipline around cost-to-collect, with prioritizing technologies that deliver measurable improvements in cash flow and have short, clearly defined ROI timelines. These dynamics are driving a deeper integration between clinical and financial workflows to better manage medical necessity/non-covered documentation and reimbursement risk. Overall we are seeing a shift from broad incremental tech investments toward a targeted solution that assists in offsetting reduced revenue leakage and improving financial performance.
Puneet Waraich, CHCIO, CDH-E. Senior Director of IT Clinical Applications for Stanford Health Care and School of Medicine (Palo Alto, Calif.): Amid ongoing financial headwinds across healthcare, organizations are under increasing pressure to reduce operating costs. This has elevated the focus on application rationalization and more disciplined, strategic contract management. At the same time, the traditional mandate of ‘doing more with less’ has taken on renewed urgency, driving more intentional prioritization across the technology portfolio.
Beyond cost containment, there is a growing imperative to build and diversify revenue streams, which are accounting for an increasing share of capital investments. Together, these dynamics are reshaping the technology roadmap, requiring more targeted investments that balance cost optimization with growth and innovation.
Ann-Marie Yap, CHCIO, CDH-E. Executive Director of Technology and Digital Solutions for Stanford Health Care and School of Medicine (Palo Alto, Calif.): Cost pressures are increasingly reshaping our technology roadmap, particularly in areas such as labor, infrastructure, and vendor spend. We are prioritizing automation and AI-enabled solutions to offset workforce constraints while improving service consistency and speed. At the same time, rising costs for cloud storage, hardware, and cybersecurity are forcing more disciplined portfolio governance — ensuring every investment is tightly aligned to measurable clinical and operational outcomes. We’re also consolidating and standardizing platforms to reduce redundancy and total cost of ownership. Ultimately, our focus is shifting from simply deploying technology to demonstrating clear value, scalability, and sustainability across the enterprise.
Romila Aloysius. Assistant Vice President of Heart and Vascular Institute for AdventHealth (Altamonte Springs, Fla.): The cost pressures reshaping healthcare today are workforce shortages, payer reimbursement friction driven by prior authorization and denials, rising drug and supply costs, increasing AI governance requirements, and persistent margin compression. As a service line leader, I prioritize technologies that create clinical capacity, protect reimbursement, reduce administrative burden, improve operational efficiency, and support sustainable growth.
This includes investments in automation, revenue integrity tools, AI-enabled workflow redesign, referral and access management platforms, and technologies that reduce unwarranted care variation through evidence-based clinical pathways and decision support.
The biggest shift is that technology is no longer funded simply because it is innovative. It is funded because it can demonstrate measurable impact on capacity, margin, growth, quality, or risk reduction. Every technology investment must have a clear operational and financial value proposition tied to the strategic priorities of the service line and the organization.
Aimee Keppinger. Director of Revenue Integrity PB for Texas Health Resources (Arlington): One of the biggest cost pressures reshaping our technology roadmap is the need to reduce the cost to collect while managing increasing administrative complexity. To address this, we’ve implemented AI-powered appeal assistance within Epic, helping teams generate appeal letters more efficiently and consistently while ensuring staff are working at the top of their license rather than spending valuable time on repetitive administrative tasks. We’re now integrating payer- and plan-specific guidelines directly into the appeal workflow, allowing AI to incorporate the exact policy language needed to better substantiate appeals. By combining automation with payer intelligence, we’re improving staff productivity, strengthening appeal quality, and increasing our ability to recover revenue without adding resources.
Charlene A. LePane, DO. Chief Medical Information Officer of Central Florida Division for AdventHealth (Altamonte Springs, Fla.): The various pressures facing health systems and the opportunities to further build healthcare experiences around the consumer helps guide our technology roadmap to ensure it meets the moment.
At AdventHealth, these pressures are sharpening our focus on tools that make the care experience better for patients and easier for clinicians to deliver. As we continue to advance our commitment to delivering whole-person care for our patients, we are prioritizing practical solutions that streamline documentation, automate repetitive tasks, improve access and throughput, and give caregivers more time to be present with the people they serve.
AI-enabled ambient documentation, workflow automation, and decision-support tools are becoming strategic investments because they can reduce friction in care delivery while supporting clinician productivity and well-being. This tech-enabled, human-centric approach helps us ensure care journeys are connected from one step to the next and deeply personalized to each patient.
At the same time, cybersecurity, data governance, and regulatory compliance remain essential. While these capabilities may not always generate direct revenue, they protect trust, strengthen resilience, and help ensure digital transformation happens safely.
Ultimately, we are evaluating technology less by novelty and more by impact: how well it improves efficiency, supports our workforce, and strengthens the care experience for patients and families.
Melissa Beckwith, BSN, RN. Chief Nursing Informatics Officer for WellStar Health System (Marietta, Ga.): Healthcare organizations are being asked to deliver greater value in an environment of increasing technology costs, including software, cybersecurity, data management, and interoperability requirements. These pressures are reinforcing a technology strategy focused on scalability, operational efficiency, positive impact to patients and clinicians, and long-term return on investment. We are prioritizing solutions that simplify workflows, reduce complexity and clinician burden, and enable caregivers to spend more time focused on patient care. Investments that strengthen interoperability, reduce clinician burden and improve patient care remain central to our roadmap.
Nipa Shah, MD. Chair of Family Medicine Department for University of Florida Health (Gainesville, Fla.): Right now, automation isn’t a luxury — it’s your cheapest hire. Inflation is pushing up everything from hardware to cloud spend, while reimbursement lags behind, forcing tighter prioritization. Additional concerns are stubborn labor shortages and rising wage costs. Meanwhile, cybersecurity and compliance aren’t optional line items — they’re the insurance premium you pay to keep the healthcare organization’s doors open digitally. The result? Every tech investment now has to justify itself quickly, with tight ROI timelines.
Deb Muro, BSN, MS, CHCIO. Chief Information Officer for El Camino Health (Mountain View, Calif.): As organizational financials are impacted by declining reimbursement and increasing expenses, it is now more important than ever to drive the realization of cost savings within the realm of technology budgets and spending. Demonstrating value while reducing cost is a key focus for today’s CIO in addition to delivering innovative and transformational products and services. The current hype cycle related to AI has surfaced as one of the immediate disruptors with cost estimates related to usage difficult to predict while the pressure to “implement AI” has led to spending that outpaces proven ROI. The funding of AI initiatives without impacting the rest of the portfolio, forces hard prioritization for today’s technology leader.
Additionally, Shadow IT driven by years of decentralized purchasing has created redundant tools, software and renewal increases that significantly surpass inflation. It is common for technology to experience repricing around AI features often at higher tiers with consolidation and license rationalization becoming recurring savings levers. Technical debt and legacy systems often consume a disproportionate share of the operating budget just to keep it functional, impacting modernization.
Last, talent costs requiring specialized skills such as cloud, security, AI/ML are expensive and hard to retain, shifting the equation toward managed services and platforms.
Penni Kyte. Digital Care Strategy Officer for Ballad Health (Johnson City, Tenn.): There are several things that are reshaping the tech roadmap. One is the refresh rate needed for all the additional technology. The second pressure is changing the culture from “elimination of positions with technology” to “re-training and expanding job duties to additional work that we have not been able to do because of capacity constraints.”
Christopher E. Smith. Chief Financial Officer and Senior Director of UT Le Bonheur Pediatric Specialists, Le Bonheur Children’s Hospital (Memphis, Tenn.): Healthcare organizations are facing sustained pressure from rising labor costs, reimbursement challenges, and increasing regulatory complexity. Those realities are pushing us to prioritize technologies that drive efficiency, improve data visibility, and reduce administrative burden. Rather than pursuing technology for technology’s sake, our roadmap is increasingly focused on solutions that produce measurable operational and financial outcomes, particularly in revenue cycle, workforce optimization, and AI-enabled automation. The goal is to create scalable processes that allow our teams to focus more time on high-value work and less time on manual tasks.
Stephanie Hines, RN, CHCIO. Senior Vice President and Chief Information Officer for Valleywise Health (Phoenix): At Valleywise Health, the cost pressures reshaping our technology roadmap are largely driven by the need to modernize while also controlling operational complexity. Labor constraints, cybersecurity risk, legacy application maintenance, and rising vendor costs are forcing us to be much more disciplined about where we invest and what we retire. We are prioritizing initiatives that reduce friction for clinicians and staff, strengthen resilience, and create measurable value—such as EHR optimization, ERP transformation, automation, AI governance, and rationalizing redundant systems. As a safety-net health system, we have to balance innovation with sustainability, so every technology decision is increasingly tied to workforce efficiency, risk reduction, and improved access to care.
Muhammad Siddiqui. Chief Information Officer for Reid Health (Richmond, Ind.): Three pressures are reshaping how we think about the tech roadmap right now. Vendor pricing is the most immediate. Several major platforms shifted to consumption-based or AI add-on pricing models this year, which makes total cost of ownership much harder to forecast. That forces prioritization conversations we did not expect to be having mid-cycle. The second is reimbursement pressure. As margins stay thin, every technology investment has to show a direct line to either revenue protection or cost avoidance. The CFO conversation has changed. It used to be about capability. Now it is about proof. The third is the gap between what AI tools promise and what they actually require to deliver. The license is the easy part. Governance, workflow redesign, clinical champions, and ongoing measurement are where the real investment lives. Most roadmaps budget for the tool and under budget for everything around it.
Ryan Curl, PhD. AI Governance Lead for SUNY Upstate Medical (Syracuse, N.Y.): Cost pressure is shaping our technology roadmap, but not simply by pushing us to spend less. It is pushing us to be more intentional about the technology we build, buy, and support. For AI, that means using models that are appropriately matched to the task rather than over-computing or defaulting to the largest/newest available tool. More broadly, it means prioritizing shared platforms, stronger data foundations, and systems that can work together instead of adding more disconnected point solutions. In that sense, the cost-effective path and the best-practice path are increasingly aligned: build systems that are interoperable, sustainable, and appropriately matched to the work they are meant to support.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.