After years of rapid digital adoption, health system CIOs are entering a more stable phase of technology strategy shaped by persistent margin pressure, workforce strain and growing expectations that IT investments deliver measurable operational return.
As organizations plan for 2026, many CIOs are stepping away from AI experimentation in favor of a more disciplined approach focused on reliability, scalability and enterprisewide value. The emphasis is less on launching pilots and more on stabilizing the technology environment for sustainable innovation.
Reliability moves from IT concern to enterprise strategy
For technology leaders, reliability is no longer a back-office metric; it is increasingly tied to growth, clinician experience and financial performance. Ryan Vervack, chief technology officer of University of Maryland Medical System in Baltimore, said his focus this year is on ensuring technology enables growth rather than distracts from it.
“I hope to grow by leveraging AI and other technologies to automate routine work, augmenting (rather than replacing) staff, and focusing on scalable design,” Mr. Vervack said. “This will help us build our solutions once and deploy them across the enterprise.”
That mandate reflects broader pressure on CIOs to reduce operational noise and focus on systems that scale. Rather than building one-off solutions, IT teams are being asked to design tools that can be reused across the enterprise.
“All of this has to be viewed through the lens of reliability, since stability is non-negotiable in healthcare,” he said. “Reducing unplanned work and standardizing platforms allows us to focus on intentional, governed innovation.”
AI adoption matures beyond pilots
As AI moves deeper into healthcare operations, CIOs are increasingly responsible for treating it as core infrastructure rather than experimental technology. At Cleveland Clinic, Chief Digital Officer Rohit Chandra, PhD, said AI is being used to reduce administrative burden while advancing quality and safety.
“We’re focused on using artificial intelligence as a catalyst for enhancing quality and safety and transforming care delivery — making it smarter, more predictive, and patient-focused,” Dr. Chandra said.
Administrative use cases are a key entry point, particularly as systems work to ease clinician burnout and improve efficiency. The focus on optimizing the human workforce is critical as so many organizations face workforce shortages and increasing demand for care. Health systems are bracing for the potential impact of ACA subsidy and Medicaid cuts, which may lead to more uncompensated care and thinning resources.
If the workforce is more comfortable with AI and automation now, the organization will be able to continue building on the success.
“Tools such as AI scribe and AI-driven medical coding will continue to reduce administrative friction, allowing us to focus on personalized experiences and outcomes,” Dr. Chandra said. “Ultimately, our vision is a future where operational enhancements fuel growth, and growth accelerates our ability to deliver care that is not only efficient but profoundly centered on each patient’s journey,” he said.
Discipline replaces early adoption
Financial constraints and operational complexity are forcing a more selective approach to AI adoption. Neil Roy, MD, vice president of diagnostic and operative services and chief medical officer at Adventist HealthCare in Gaithersburg, Md., said his system is focused on efficiency rather than volume, particularly given Maryland’s global budget model.
“Margin in this model comes from efficiency and value,” Dr. Roy said. “From a surgical standpoint, that means focusing on more complex cases with short lengths of stay and lower variable costs. That reality really shapes how we think about growth.”
That reality has shaped how the system evaluates technology investments. Hospitals receive a global fee for community care, and are responsible for any overages. If the hospital keeps community care under the global fee, the organization keeps the differences. Because of the model, Maryland hospitals aren’t focused on doing more volume. Dr. Roy said his system is focused on investing in clinicians and optimizing the EHR as well as using proven technologies like ambient AI and OR scheduling.
“[We are] staying laser-focused on length of stay by improving interdisciplinary rounds, better leveraging inpatient hospice and working more closely with nursing facilities to avoid unnecessary delays,” he said. “This is really about disciplined growth, not growth for growth’s sake, so we can stay stable and still move forward.”
Application rationalization becomes an AI strategy
As AI investment accelerates, CIOs are also confronting the cumulative cost and complexity of their technology environments. Chad Konchak, system assistant vice president of data analytics at Endeavor Health in Evanston, Ill., said managing that complexity has become a central priority. Rather than continuing to add point solutions, his team is reassessing the application portfolio.
“Our focus is on rationalizing our applications and prioritizing core platforms that can deliver multiple capabilities rather than continuing to add complexity,” he said. “With the growing attention and investment in AI, this discipline is even more important to ensure our technology decisions remain financially responsible and operationally sound.”
AI discussions must start with operational reality rather than technology capabilities. Brandi Fields, DNP, RN, vice president of clinical services and quality improvement at UK King’s Daughters in Ashland, Ky., said her team is closely monitoring how resources are used across the organization.
“[We are] continuously questioning the status quo to improve team workflows, enhance patient care, and, ideally, support stronger financial performance,” Ms. Fields said. “Exploring new ways of getting the work done — can we leverage AI or other technologies to help us overcome long-standing workflow barriers?”
Other industries serve as a model for AI possibilities in healthcare. Dr. Fields pointed to the airline industry as AI is optimizing the movement of baggage staff across airports to leverage team efficiency and ensure critical flight schedules are kept. There are parallels in the healthcare industry, where urgency and timing are critical to positive patient outcomes.
“We should consider how similar principles could be applied in healthcare,” she said. “For instance, our phlebotomy teams cover a large, complex hospital footprint and must prioritize timed, stat and routine lab draws. Currently, staff rely on experience and judgment to decide which floors to visit and in what sequence, which can result in delays for time-sensitive labs.”
Leveraging AI or advanced routine technology can optimize the daily workflows and map the most efficient paths, prioritize tasks and reduce delays.
“Implementing such tools could be a true game-changer, improving both patient care and operational efficiency,” she said.
CIOs pulled deeper into value-based strategy
As payment models shift and margins remain tight, IT leaders are also playing a growing role in enabling value-based care. Nolan Chang, MD, executive vice president of strategy, corporate development and finance at The Permanente Federation, said integrated care models depend on technology to align outcomes and cost.
“An integrated, value-based care model is the most effective approach for both financial sustainability and growth in the current healthcare landscape,” Dr. Chang said.
Digital tools, including AI, support that alignment by improving care coordination and operational efficiency. Health systems are building internal teams focused on AI opportunities and strengthening partnerships with an eye toward uncertainties in the future.
“The use of AI and digital health tools, such as the Kaiser Permanente Intelligent Navigator can also enhance the patient experience, guide patients to the right care, and streamline operations, ensuring efficient and effective care delivery,” he said. “In addition, true financial stability and growth in healthcare require breaking down barriers that isolate clinical care from important social determinants of health, such as financial security and environmental factors to improve overall patient health.”
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