Healthcare IT teams may be stuck in “firefighting” mode for reasons that go beyond burnout, as CIOs point to an expanding mix of upgrades, cybersecurity demands, AI projects and operational work that is increasingly outpacing their capacity.
A recent report from networking-as-a-service provider Nile found that 66% of healthcare IT teams described themselves as strained or in constant “firefighting” mode. Only 18% said they were comfortably managing network operations, while 21% described themselves as critically understaffed and at risk of burnout.
The Aug. 18 report surveyed more than 300 IT leaders, C-suite executives and network and security practitioners across the global healthcare sector.
But staffing alone did not explain the strain. Fully staffed teams reported similar levels of firefighting, according to Nile, pointing to network complexity as another underlying factor.
For two health system CIOs who spoke with Becker’s, that finding reflects a broader shift in healthcare technology. IT teams are being asked to manage more systems, respond to faster vendor release cycles, support expanding cybersecurity requirements and take on AI, all while keeping existing technology running.
“I do think that it resonates, but I think the real issue is less about firefighting; it’s more on the pace of demand, honestly,” Sonney Sapra, CIO of Charlottesville, Va.-based UVA Health, told Becker’s.
IT now touches clinical care, research, education, digital transformation, cybersecurity, AI adoption and operational efficiency, Mr. Sapra said.
“It’s truly the pace of demand at this point, and it’s truly outpacing the capacity that we have,” he said.
Muhammad Siddiqui, CIO of Richmond, Ind.-based Reid Health, sees a similar problem, but said the term “firefighting” can obscure how much of the pressure comes from work organizations know is coming.
“It suggests unplanned work, and that is only half of it,” Mr. Siddiqui told Becker’s. “My teams are strained because the planned work never stops either. Every quarter brings a release, an upgrade, a new integration, a new security control. The fire is real. The bigger problem is that there is no season when the building is not under construction.”
The workload itself is changing
Nile’s survey found cybersecurity and ransomware were the top network challenge for healthcare organizations, cited by 27% of respondents. Staffing shortages and lack of expertise followed at 23%, along with rising operational and compliance costs at 20% and aging or fragmented infrastructure at 15%.
About 85% of respondents said their organizations experience network or security disruptions frequently, including 38% who reported disruptions at least weekly. Those events can affect systems supporting EHR access, patient monitoring and imaging workflows, according to the report.
Mr. Siddiqui said one overlooked source of strain is how quickly vendors are now updating their products.
“Our core vendors used to ship major updates every 12 to 18 months. Now it is quarterly, with more code in every release,” he said. “At the same time the security expectation has moved from patch within 30 days to patch urgently. More code, arriving more often, with less time to test it. That is a structural change in the work, not a temporary spike.”
Cybersecurity has also shifted from a periodic responsibility to a continuous one, he said, while third-party security incidents can pull health system IT teams into responses to events they did not cause.
AI is adding another layer.
“Everybody wants the shiny new tools with AI,” Mr. Sapra said. “Everybody wants to be involved in bringing newer things in.”
That makes prioritization increasingly important, he said. Before adopting a new technology, organizations need to be clear about the problem they are trying to solve and the measurable outcome they expect.
Health systems can otherwise jump too quickly to technology when operational workflows, people or processes may be the real issue, he said.
“Otherwise, we’re spending a lot of time on solutions that may or may not help the organization,” Mr. Sapra said.
Mr. Siddiqui said health systems also need to account for what happens after a technology is purchased.
“Most technology creates net new work in year one,” he said. “If you approve the purchase without approving the operational load that comes with it, IT absorbs the difference silently.”
At Reid Health, every new capability must have an operational owner outside of IT before receiving a go-live date. AI use cases are reviewed for clinical risk, privacy, model performance and cost before deployment, and the organization looks to retire existing technology as it adds new capabilities.
“Application rationalization is not a cleanup exercise,” he said. “It is workload management.”
Burnout can show up before turnover
The strain may also be difficult for executives to recognize before it begins affecting an IT organization.
“It rarely looks like someone falling apart. It looks like quiet erosion,” Mr. Siddiqui said. “Documentation stops getting updated. Small improvements stop happening because everyone is heads down on tickets. Your strongest people start declining projects they used to volunteer for.”
Turnover can come later, he said, after an organization has already lost institutional knowledge that is difficult to replace.
Mr. Siddiqui said he watches the ratio of planned to unplanned work, whether change requests are being meaningfully reviewed and how frequently the same employees appear in after-hours escalations.
“If one engineer is the answer to three different problems, that is not depth,” he said. “That is a single point of failure with a pulse.”
Mr. Sapra also watches for the moment when IT teams become so consumed by immediate demands that they stop looking ahead.
“One of the biggest warning signs for anything that has to do with burnout and your team feeling stretched is they become more reactive and they stop asking for innovative things,” he said.
When that happens, CIOs need to work with operational leaders to narrow priorities and reconnect technology work to the health system’s broader strategy, he said.
The work executives do not see
Part of the challenge, Mr. Siddiqui said, is that much of healthcare IT’s workload is largely invisible when technology is working as intended.
Health system leaders can view IT as a collection of projects, when much of the job involves maintaining hundreds of integrated systems while simultaneously changing them.
That work is “closer to maintaining a bridge while traffic crosses it,” Mr. Siddiqui said. “When the bridge holds, it looks like nothing happened.”
The same dynamic applies to preventive cybersecurity work.
“Nobody sees the vulnerabilities remediated or the outage that never occurred,” he said. “So when budget season comes, the team that prevented the crisis looks less essential than the team that responded to one. That math is backwards, and it is on CIOs to tell that story better than we have.”
Mr. Sapra said seemingly simple requests can carry a similar hidden workload. A project that an operational leader expects to require 10 or 15 hours can take 80 hours once integrations, workflow changes, training and change management are accounted for.
“There’s sometimes a misconception on what it takes to bring a solution forward,” he said.
For Mr. Sapra, addressing the broader strain facing IT ultimately comes down to aligning technology investments with strategic priorities, measuring their outcomes and ensuring innovation creates capacity rather than adding complexity.
“The organizations that are more successful with this really align their technology investments with the strategic priorities, and they measure those outcomes,” he said. “Innovation creates more of that capacity, as opposed to working against that capacity.
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