In today’s U.S. healthcare environment, technology is both a lifeline and a liability. On one hand, digital systems allow providers to deliver care more efficiently, track patient data with unprecedented accuracy, and connect teams across large networks. On the other hand, the very infrastructure meant to unify care is often fragmented into dozens of separate platforms.
HIMSS Analytics (2024) reports that the average hospital manages more than 16 EHR and clinical systems, with large health systems often exceeding 25. Each system comes with unique interfaces, security risks, upgrade cycles, and maintenance contracts. Over time, these layers of complexity create operational drag, inflate costs, and limit innovation.
This fragmentation isn’t just an IT inconvenience—it’s a patient care issue. When clinicians can’t easily access a complete patient history, critical decisions are delayed. When researchers have to pull data from siloed databases, groundbreaking studies are slowed. And when compliance teams must track retention rules across multiple platforms, the risk of regulatory breaches rises sharply.
The root cause? A mix of organic technology growth, departmental procurement, and a steady stream of mergers and acquisitions that bring legacy systems into the fold.
The average U.S. hospital’s IT landscape has evolved far beyond a single EHR platform. Over the past two decades, hospitals have adopted specialized systems to meet the needs of various departments—radiology, pathology, pharmacy, billing, scheduling, and research—each with its own vendor and integration requirements.
In large systems, especially those operating across multiple states, these numbers can be even higher. When hospitals acquire smaller facilities, they inherit not just patient populations but entire technology stacks—often without a unified plan for integration.
The operational effects are significant:
Duplicated effort: Nurses may enter the same patient note into multiple systems.
Delayed care: A physician waiting for lab results may need to log into a separate portal, requiring additional authentication.
Training burdens: IT teams must maintain training for dozens of interfaces, eating into budgets and productivity.
And the problem is growing. According to Kaufman Hall (2024), there were 53 hospital mergers and acquisitions in 2023 alone. While M&A can bring economies of scale, it also compounds IT complexity.
Maintaining outdated or redundant systems isn’t just inefficient—it’s expensive. CHIME (2023) estimates that keeping a legacy EHR or clinical application operational can cost $50,000 to $200,000 per year per system. For a medium-sized hospital with 18 systems, that’s anywhere from $900,000 to $3.6 million annually, and those figures exclude indirect costs.
Beyond the direct expenses, hidden costs add up quickly:
Staff time: IT teams spend countless hours maintaining integrations, applying patches, and troubleshooting system-specific issues.
Security risks: Older systems often run on unsupported operating systems, leaving them vulnerable to cyberattacks.
Compliance exposure: HIPAA requires strict access controls and audit capabilities; legacy platforms may lack these features.
Interoperability is also a cost center. KLAS Research (2023) found that 62% of U.S. health systems report interoperability gaps that negatively affect patient care. Common consequences include delayed discharge summaries, incomplete medical histories, and medication reconciliation errors.
When systems can’t communicate, every patient transfer, every cross-specialty consult, and every research project becomes a manual data hunt.
How many vendors do you have providing data services to your health organization? 10, 20, More? Healthcare is deep with outsourcing across several providers even when you think your vendor "offers it all". Every additional vendor relationship adds layers of complexity:
Separate contracts and renewal cycles
Different service-level agreements
Misaligned software updates and patch schedules
Vendor consolidation—partnering with a single provider to manage data migration, archival, streaming, and disaster recovery—offers measurable benefits:
Reduced overhead: Fewer contracts to manage, less administrative burden.
Lower costs: Elimination of redundant licenses and infrastructure.
Improved security: Centralized oversight of access controls and data protection.
Consistent compliance: One set of audit logs, one governance framework.
From a strategic standpoint, consolidation turns IT from a reactive cost center into a proactive driver of improving patient care and clinical innovation.
Consider a multi-hospital network operating across three states. Over decades of expansion, the system accumulated 47 legacy applications—a mix of inpatient and outpatient EHRs, departmental databases, and specialized clinical systems.
The challenges were clear:
Annual maintenance costs exceeded $6 million.
Clinicians needed to log into multiple platforms to retrieve complete patient records.
Research teams faced weeks-long delays compiling datasets for studies.
The consolidation process included:
Inventory and assessment of all legacy systems across their health system and affiliates.
Phased decommissioning of non-essential platforms over the course of 7 years.
Data migration to modern, interoperable systems with a focus on domain consolidation to inpatient EHRs.
Archival of historical data in a secure, accessible repository with single sign-on for providers.
Change management and training for all staff in an on-going capacity.
Results:
65% reduction in annual maintenance costs—a savings of nearly $4 million per year.
Single secure access point for all clinicians, reducing time to retrieve records from minutes to seconds.
Research teams gained instant access to longitudinal patient histories, accelerating trial recruitment and study completion.
This transformation didn’t just save money—it improved care quality and enabled innovation.
Even with the clear benefits, many health systems hesitate to consolidate due to concerns about disruption, cost, and risk. Bring prepare to speak to the cost reduction, return on investment and operational aspects for all stakeholders is critical to move through the process.
Common Objections vs. Mitigation Strategies
| Objection | Mitigation Strategy |
|---|---|
| “The transition will disrupt care” | Phased migrations during low-volume periods, temporary dual-system access |
| “It’s too expensive to consolidate” | ROI modeling showing long-term savings, vendor financing options |
| “We can’t risk losing data” | Comprehensive verification protocols, redundant backups during migration |
Change management is critical. Engaging clinicians early, offering targeted training, and maintaining transparent communication throughout the process ensures buy-in and smooth adoption.
A consolidated, interoperable data environment does more than solve today’s problems—it enables tomorrow’s breakthroughs:
AI-driven clinical decision support for personalized treatment plans.
Population health analytics to identify at-risk groups and prevent hospitalizations.
Predictive modeling to anticipate patient deterioration and reduce readmissions.
Accelerated clinical research through instant access to complete datasets.
In a healthcare economy increasingly driven by value-based care and data-driven decision-making, having a unified, reliable data infrastructure is no longer optional—it’s a competitive advantage.
Fragmented health IT environments drain budgets, slow care, and limit innovation. The data is clear:
Most hospitals manage 16+ systems; large networks exceed 25.
Legacy system maintenance can cost millions annually.
Interoperability gaps affect over 60% of U.S. health systems.
For health IT leaders the choice is stark: continue managing an ever-growing tangle of systems or take decisive action to consolidate and modernize. The financial, operational, and clinical benefits of consolidation far outweigh the challenges—especially when executed with a proven, structured approach.
Need help getting started? Hart offers a initial data management assessment at no cost to you. Reach out to the team today