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If you had asked me 10 or 15 years ago how many applications a hospital or health system should reasonably manage, I probably would have laughed before answering. Not because the question wasn’t important, but because even then, most of us knew the number was already too high.
Fast forward to today, and the problem hasn’t gone away. In fact, it’s grown. Most healthcare organizations manage anywhere from 400 to 1,000 applications, and large integrated delivery networks can easily exceed that, sometimes reaching 2,000 applications after years of mergers and acquisitions.
When I was a health system CIO, if someone told me they were managing only 150 applications, I would have said, “You’re doing great—tell me how you pulled that off.”
That reality is why application rationalization, also referred to as application consolidation (app con), has moved from a “nice-to-have” initiative to a strategic necessity.
What is application rationalization in healthcare?
Application rationalization is the strategic, data-driven process of evaluating an organization’s software portfolio to eliminate redundancies, reduce cost, and improve operational efficiency.
Let’s be honest: app con is complex, time-consuming, and often politically delicate. Every application has a champion. Every department has a reason why their system is different. And when you’re running lean IT teams while responding to daily operational fires, it’s tempting to push app rationalization to “next year.”
But the longer we delay, the more expensive (and risky) it becomes.
Healthcare didn’t end up with bloated application portfolios overnight. We added systems to solve immediate problems, comply with regulations, or support new service lines. Over time, those decisions compounded.
App con is about stepping back, asking critical questions, and then acting on the answers.
Which applications are truly delivering value?
Where do we have overlapping functionality?
Are our teams using the tools we already pay for?
The impact of too many applications on clinicians and staff
When application portfolios spiral out of control, the impact goes far beyond IT.
From a technology standpoint, CIOs immediately feel the pressure:
Rising costs from licensing, integrations, and maintenance
Cybersecurity exposure from outdated or underutilized systems
Interoperability challenges caused by fragile, custom-built interfaces
Time lost to annual vendor assessments and security evaluations
But the real pain shows up on the front lines. Clinicians today are navigating fragmented workflows that span multiple systems, often just to complete a single task. It’s no surprise that utilization suffers. When nurses and physicians are forced to choose between dozens of tools, they either don’t use them fully or they disengage altogether. In my experience, that’s when we start hearing, “This software doesn’t work,” even when the problem isn’t the tool itself, but the ecosystem surrounding it.
Add to that the reality that clinicians now spend an average of 88 minutes a day on administrative tasks, and it becomes clear that excess technology isn’t helping—it’s contributing to burnout.
Financial Pressure makes application rationalization essential
Healthcare organizations are facing unprecedented financial strain. Federal funding reductions, Medicaid uncertainty, rising labor costs, and increasing uncompensated care are compressing margins, especially for rural, pediatric, and Medicaid-heavy facilities. Technology is often seen as part of the problem because it represents significant spend.
But I believe technology is also a big part of the solution—if it delivers real financial and operational benefit.
Reducing redundant applications can:
Eliminate unnecessary licensing, hardware and support costs
Improve adoption of the tools you keep
Free up resources to invest in platforms that scale
In fact, many organizations now have explicit application consolidation initiatives designed specifically to take cost out of the technology stack while improving performance and reducing risk.
Cybersecurity risk and the rise of shadow IT
One issue that keeps CIOs up at night is security, and rightly so.
Every application is a potential entry point for a cyberattack. Redundant or rarely used systems are often the least maintained and the least patched, making them attractive targets for ransomware. Consolidation directly reduces the attack surface.
At the same time, shadow IT continues to surge. According to our annual symplr Compass Report, more departments are purchasing software outside formal governance than ever before. That number has climbed steadily from 74% in 2022 to 81% in 2024, and now 86% in 2025.
This trend increases risk, fragments data, and undermines interoperability. Application rationalization gives CIOs a way to regain visibility and control without stifling innovation.
Platform consolidation: the shift that matters most
One of the most important shifts in healthcare IT is the move away from isolated point solutions toward integrated platforms.
Platform consolidation enables organizations to standardize workflows, improve interoperability, and reduce administrative burden. More than 75% of healthcare leaders say a consolidated healthcare operations platform would help address inefficiency and administrative complexity.
Platforms also make it easier to demonstrate value. When data flows across systems and workflows are aligned, CIOs can more clearly connect technology investments to outcomes like clinician satisfaction, operational efficiency, and financial performance.
What application consolidation means for the modern healthcare CIO
The role of the healthcare CIO has evolved. Today’s CIO is not just managing technology. They are shaping business strategy.
Leadership expects CIOs to:
Tie technology spend to patient outcomes and financial resilience
Reduce clinician burden and improve workforce satisfaction
Break down silos across clinical, financial, and operational teams
Lead governance, change management, and ROI accountability
Application consolidation sits at the center of this evolution. It requires collaboration with clinical, financial, and operational leaders. It also requires focusing on process alignment, not just technology reduction.
Technology alone does not solve inefficiency. Aligning systems with how care is delivered does.
Where to start with application rationalization
For CIOs wondering how to begin, my advice is simple. Start where it hurts most.
Look for workflows that are fragmented, expensive, or frustrating. Identify systems that are underutilized or duplicative. Engage clinicians and operational leaders early so consolidation decisions are informed by real-world experience.
Application consolidation done well does more than reduce cost. It restores capacity, improves experience, strengthens security, and positions organizations for long-term resilience.