Technical Debt Is Quietly Killing Your IT Strategy 

Why CIOs Say Application Rationalization Is the Best Line of Defense

If your IT application portfolio were a closet, half would still have tags. A quarter wouldn’t fit. And the rest? No one remembers buying.

In hospital IT environments, the more outdated apps you’re managing, the more it stops being clutter and starts killing your strategy.

Why? Because IT sprawl drains budgets. Fractures operations. Multiplies risk. And drags your team into meetings just to ask, “What does this tool even do?”

During a roundtable with CIOs from three leading healthcare systems and MediQuant President and CEO Jim Jacobs, one message rang clear:

You don’t get clean data or smart decisions from a tech stack full of ghosts.

Application rationalization is the foundation of every data-driven strategy worth trusting.

Outdated Apps Don’t Disappear. They Just Get More Expensive.

Bloated tech stacks don’t start with bad decisions. They start with delayed ones. Every “we’ll deal with it later” adds weight: another license. Another risk. Another application that’s collecting dust and draining budget.

Mergers and acquisitions only raise the stakes. Julie Eastman, Sr. VP and CIO at UCI Health, experienced it firsthand when her health system ballooned from 420 to 1,300 beds in a year. With that growth came a flood of mismatched applications, new datasets, and competing database structures.

Each one had to be assessed, aligned, and integrated. And like most HIT leaders navigating the increasingly familiar IT terrain involving M&As, she knows duct-taping a tech stack that was never built to scale isn’t a strategy—it’s a liability.

Because when internal pressure collides with aggressive M&A timelines, things can easily slip. Apps get lost. Inventories go stale. And suddenly, you’ve got zombie software: unused, unpatched, and still quietly expanding your attack surface.

Tom Barnett, Chief Digital and Information Officer at Baptist Memorial Health Care, said it simply: “You end up with an application spread—or a sprawl—that can quickly, if not governed and managed appropriately, grow to become unsustainable.”

An unstainable IT environment is more than an inconvenience. It’s expensive. Risky. And completely avoidable if you act before the sprawl starts acting for you.

Application Rationalization Isn’t Cleanup. It’s Control.

Done right, application rationalization isn’t just another tech project, it establishes enterprise-level strategic direction. It’s how CIOs turn sprawling portfolios into scalable, secure, data-driven business foundations that support their organization’s mission and operations.

Jim acknowledged a promising shift in perspective he’s seeing more organizations adopt towards their data management strategies, including healthcare data archiving solutions: “Hospitals are starting to realize they need more than just an inventory. They need a codified approach: What can be archived? What’s duplicated? What’s worth keeping?” 

Application rationalization delivers:

 ✅ Fewer, “What is this even for?” moments: Hidden costs from underused applications add up fast. Overlapping tools. Legacy fees. Redundant licenses. It adds up—until someone calls it.

✅ Minimized risk exposure: Every application is a breach point. Streamlining isn’t just good practice. It’s protection.

✅ Unlocked agility Once you’ve performed application rationalization properly, a streamlined IT portfolio helps position your healthcare data as a strategic asset.

Legacy ≠ Valuable. Familiar ≠ Useful.

Application rationalization doesn’t fail because the logic isn’t solid. It’s what happens when sentimentality wins.

People cling to what’s easy. What’s known. What they see and use every day.  Even when the tools no longer serve the mission, they often hold on like they’re protecting heirlooms without understanding this is creating roadblocks to the transformation that will ultimately serve them better.

But here’s the truth: familiarity is friction. It slows IT teams down. Inflates budgets. Breeds risk. That’s why rationalization can’t be treated as an IT housekeeping chore, it has to be an enterprise-wide clarity play.  This starts with education.

Jackie Rice, VP & CIO of Frederick Health, frames it simply: start with the inventory. Map usage logs, calculate total cost, surface compliance risks, track outcomes. Then make the case with documentation, acknowledging users’ needs with those of the larger organization.

“Asking someone to give up an app they “love” is personal, until you show them what it’s costing the business. Then it’s just math”.

If you want people to absorb change, let them help shape the outcome. Involve operations, finance, compliance, and governance upfront, not as an afterthought.

What These IT Leaders Wish They’d Done Sooner

Every HIT leader has a lesson. Here’s three you can steal today for a pain-free application rationalization process that yields measurable results:

1. Lock in executive backing early: Waiting until your tech stack’s on fire won’t buy you grace. Lay the political groundwork up front.
2. Translate every tech request into business value: If someone’s begging for a new app, remember that establishing a business case is more important than the pitch deck.
3. Make application rationalization a mindset, not a milestone: This isn’t a spring-cleaning project. Keeping your digital clutter from accumulating requires an investment of time and ongoing commitment.

The Hidden ROI in Technical Debt

💸 Up to 30% TCO Reduction
Organizations following application rationalization best practices can reduce total cost of ownership by up to 30%.
Source: Orbus Software

💰 $30–$75M in Cost Savings
A $22B global pharmaceutical firm found $30–$75M in cost optimization opportunities via rationalization.
Source: Gartner

🧯 80% of IT Budgets Go to Legacy Maintenance
Legacy systems drain IT budgets, leaving little room for innovation.
Source: Oracle

So… What’s in Your Stack?

And more importantly—how much are you still paying for it?

If you can’t answer either, it’s not a sign of failure. Take it as a sign you’re ready to start leading differently.

When you’re ready to reclaim your portfolio, reinforce your strategy, and finally realize the ROI your organization deserves let’s talk.