The complexity of managing clinical, administrative, and operational applications in healthcare organizations continues to grow. While many large hospital systems have invested in robust programs to streamline their application portfolios, any health system that has undergone ownership changes, faced prolonged under resourcing or shifting priorities grapple with technical debt and legacy systems that quietly drain resources and introduce risk. Application rationalization is not just a cleanup task—it’s a strategy that can yield measurable operational and financial benefits, even without a large team to execute it.
The Hidden Cost of Application Sprawl
Application portfolios in healthcare environments tend to grow over time as new needs emerge and priorities shift. Legacy systems, departmental tools, and redundant applications can quietly accumulate, while consolidation becomes more complex from mergers and acquisitions, creating technical debt and operational inefficiencies. One regional health system uncovered over 700 applications—nearly triple their initial estimate—after a thorough inventory. The result? $17 million in savings in the first year and $72 million over five years, all without a massive team or predefined playbook.
Why We AppRat: Benefits Beyond the Balance Sheet
While cost reduction is a compelling driver, the return on investment from AppRat extends far beyond the balance sheet. Healthcare leaders often delay AppRat due to competing priorities, perceived disruption, or lack of internal expertise – including rationalizing legacy systems where no one on the current team has a full understanding of. Rationalization efforts have led to a 30% reduction in IT support tickets, 20–25% improvements in clinical workflow efficiency, and enhanced data interoperability. These operational gains translate into better clinician experiences, faster decision-making, and ultimately, improved patient care.
Start Small, Think Big
The challenge often lies in knowing where to begin. Many organizations believe they have a handle on their application inventory, until they start digging and discover hidden redundancies, unsupported systems, data silos and cybersecurity risks. Begin with a simple inventory and build from there, tailoring the approach to each organization’s unique bandwidth and priorities.
A phased assessment approach—starting with inventory validation and business function mapping—can uncover opportunities to reduce licensing costs, simplify workflows, and improve data governance.
Why Rationalization Matters
Decommissioning a single application can bring significant savings and risk reduction. But application rationalization isn’t just an IT exercise; it supports the most strategic organizational goals. By consolidating systems and eliminating outdated platforms, healthcare providers can improve clinician experience, reduce login fatigue, and streamline training. Standardization enhances interoperability, supports regulatory compliance, and strengthens cybersecurity posture by reducing exposure to vulnerabilities in legacy systems. These improvements contribute to better patient care and operational resilience.
Importantly, the return on investment extends beyond direct cost savings. Rationalization efforts often lead to reductions in IT support tickets, improved onboarding processes, and enhanced clinical workflow efficiency. These outcomes translate into cost avoidance and increased capacity for innovation. Organizations can redirect resources toward strategic initiatives such as AI adoption, cloud migration, or digital transformation.
AppRat Progress Without the Army to Do It
Success does not require an army—it requires a thoughtful, repeatable process. Engaging stakeholders across IT, clinical, finance, and compliance teams ensures that decisions are informed and aligned with organizational priorities. Leveraging existing tools and frameworks can accelerate progress and reduce the burden on internal staff. Whether starting with a simple assessment or building a full application lifecycle management program, the key is to embed rationalization into the fabric of IT operations.
For organizations without the bandwidth or specialized expertise to manage this work, partnering with a team that can both assess and execute is critical. We help health systems identify opportunities through structured assessments and then manage the legacy turndown process – reducing risk, freeing resources, and creating a faster path to ROI so that teams can focus on strategic priorities like digital transformation and innovation.
