Amy Penning, Senior Application Analyst, CereCore
Health system IT executives recognize that application rationalization is essential: it reduces risk and costs while improving manageability across the IT enterprise. Yet the process is complex from both leadership and technical perspectives. In this column from our Partner Perspectives series, Amy Penning, Senior Application Analyst at CereCore, presents a practical plan for tackling this critical initiative.
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 will grapple with technical debt and legacy systems that quietly drain resources and introduce risk. Application rationalization (AppRat) is 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, illustrating the criticality of the discovery phase of AppRat.
When an organization’s application inventory expands well beyond what was initially thought to be, business function mapping becomes vital. This process illustrates redundancies, painting a better picture for leadership of where the quick wins exist. In the example of the regional health system above, the organization was able to claim $17 million in savings in the first year and $72 million over five years. Those savings were attained by sunsetting appropriate applications, utilizing information gathered to revisit contracts and moving to enterprise agreements, and implementing data archival.
Why 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 the apps inner workings.
When organizations have home grown, legacy, mainframe or any other applications that require specialized support and understanding, it’s imperative to document and knowledge share. Many organizations believe these apps will be gone before the subject matter expert is, but the reality is reorgs, retirement, and layoffs happen. Outside of day-to-day support functions being documented, there is other vital information required to be prepared to handle these apps when it comes time to sunset. Below is a table that illustrates the information you should collect while you have the experts available.
Creation and upkeep of documentation for applications should be an integrated part of the everyday workflow for application owners or subject matter experts. Is there a change to any of the data in these fields? Update in real time. It will prevent potential painful experiences and allow for better planning when it comes time to archive and decommission.
In addition to ensuring vital information is recorded for each application as it relates to sunsetting, the improvement in supporting those apps that also comes from this process is another big win. 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
While you now have an understanding of the vital information all organizations should have for each of their applications, it’s important to use a wider lens to know where to start when building an application inventory. 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.
While it may seem straightforward, there are some key things to be aware of when going into this process. Common mistakes can prevent building an accurate and robust portfolio inventory. See some examples below:
Be ready to learn from and document your own lessons learned as you perform this important work. A robust application lifecycle/portfolio management program is ever evolving, and application rationalization informs overall portfolio health, supports strategic alignment and enables those lifecycle decisions.
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 ROI 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. While the stakeholder engagement can be a challenge with jam packed schedules and many competing priorities, it’s good to come prepared.
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 implement workflows that support real time application inventory updates. From contract edits, to app version updates, to ownership, to disposition changes, it’s imperative that it becomes routine to manage this information. Additionally, having consistent governance over your application portfolio ensures that it is aligned with your organizational goals and strategic initiatives.
For organizations without the bandwidth or specialized expertise to manage this work, partnering with a team that can both assess and execute is critical.
CereCore 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.
