​Why Healthcare Needs An 'Application Undertaker'

gettyWith 30 years in healthcare IT, I’ve seen how our industry traditionally defines innovation. Most of the attention, funding and executive energy go toward implementation, whether it’s launching a new platform, completing an electronic health record (EHR) migration or moving to the cloud.

That emphasis made sense during the first era of digitization. Organizations created “chief digital officer” roles because transformation required a dedicated executive to accelerate adoption. However, years of technology investment, replatforming and M&A have created sprawling portfolios that few organizations were structured to simplify. AI is changing the leadership mandate, and healthcare now needs an equally deliberate focus on strategic subtraction.

Gartner, Inc. coined that job the “application undertaker.” In practice, the role might be a chief applications officer or a vice president of application portfolio management. Whatever the title, organizations need a dedicated person to establish the governance, operating discipline and accountability required to retire applications continuously as a regular discipline.

The case for application portfolio management isn’t new. Health systems have long known that redundant applications consume operating dollars, create technical debt and increase cybersecurity risk. AI may be the factor that finally tips the scales.

AI depends on reliable data that’s accessible across the enterprise and available in consistent formats. That remains difficult when information is scattered across disconnected applications, in proprietary formats and departmental silos. Application rationalization is an essential first step.

Retiring the application is only half the work, though. Health systems also benefit from preserving and activating historical data.

Done well, active archiving supports longitudinal medical records and enterprise analytics across clinical, financial and operational domains. It allows health systems to draw on years of historical context. At the same time, retiring obsolete systems frees resources for AI and other strategic priorities.

Even as CIOs name cost reduction as one of their top priorities and acknowledge application rationalization as essential, portfolio cleanup consistently gets pushed to the back of the queue. New technologies are routinely approved—filling implementation road maps three to five years out. Because the front of the pipeline is perpetually clogged with new rollouts, retiring legacy systems becomes the task leaders never quite get to.

With the relentless pace of innovation, this cycle will persist until health systems shift from passive intent to an active “application undertaker” operating model. Reaching that state requires ownership across three areas:

​The leader must maintain a current view of the application portfolio, including each system’s business function, cost, usage, contracts, dependencies, data and risk. That analysis should reveal where capabilities overlap, where workflows can be standardized and where systems can be consolidated onto more strategic platforms. It becomes the road map for modernization, not just retirement.

A cross-functional governance body should then use that evidence to decide what stays, what consolidates and what enters the next retirement wave. Priorities should reflect recurring cost, cybersecurity exposure, contractual expiration, data complexity, business readiness and strategic value.

Application retirement can’t be an IT-only decision. The application undertaker must create the evidence and governance process that allow leaders across the organization to agree on what stays, what consolidates and what can be retired. This goal is to establish a repeatable process that aligns business and IT around the future-state portfolio and keeps modernization and retirement moving together.

​The leader must work with finance to build a funding model that connects capital investment to permanent operating expense reduction. Where appropriate under the organization’s accounting policies, eligible technology-related implementation work may be funded through capital budgets, while operating expense savings are realized through terminated licenses, hosting, maintenance, support and infrastructure.

Finance and IT should establish the true cost baseline for each application, verify that projected savings actually leave the operating budget and use those results to support future waves of retirement.

The leader must also secure the project management capacity internally or externally to keep business owners, data teams, vendors, contract deadlines and shutdown activities aligned. Without dedicated execution, even a compelling business case will stall before the savings are realized.

​The work isn’t complete when users stop logging into an application. Historical data must be extracted from vendor-controlled systems, converted into usable formats, tested against source records and validated by the people responsible for the information. Access must remain secure, role-based, auditable and compliant with legal and regulatory requirements.

Only then can the organization complete the retirement by terminating the vendor contract, shutting down production and nonproduction environments, removing interfaces, retiring infrastructure and confirming that recurring costs have actually left the operating budget.

Together, these three disciplines create an enterprise assembly line. Applications enter through continuous portfolio analysis and cross-functional prioritization; move through funded execution, data acquisition and validation; and exit only after the application, infrastructure and recurring cost have been fully removed.

​The “application undertaker” title may be a bit aggressive, albeit accurate. Organizations can choose other titles, but every health system needs one accountable leader with the authority, funding strategy and operating model to simplify the application portfolio continuously.

How that capability is built will vary. Some organizations will develop it internally. Others will rely on outside expertise. Most will use a combination of both.

What matters is that ownership remains clear and the work has enough dedicated capacity to continue beyond a single project. Organizations must create a standing enterprise capability that converts technical debt into permanent margin improvement and turns inaccessible historical data into a strategic asset.

Gartner predicted (registration required) that by 2031, 70% of large enterprises will make the archive the primary home for historical data rather than production applications, up from 40% in 2026. Health systems that want to capture that opportunity can’t wait until an AI initiative is underway to address the applications and data beneath it.

Retiring legacy systems is about liberating the data needed to power the future of healthcare.​

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