At HIMSS ‘26 our CRO Jenifer Baird shared some enlightening stats on the high cost of fragmentation across the industry and the reality (often failure and friction) of modernization efforts.
Did you miss Jenifer’s Planetary Scale Video? Watch it here.
Modernizing partial or complete architecture is a complex, multi-year process that touches every system, department, process, workflow and person. It is not a check-the-box approach, and has implications across security, privacy, auditability, governance and several essential functions.
Use the assessment below to evaluate how your internal departments are managing cost, efficiency and change, beyond just the technology.
Operational Efficiency and Governance
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How many independent systems and platforms currently make up your operational architecture?
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How is your organization currently maintaining the complexity of multiple systems, including maintenance spend, IT effort, technical debt management and coordination costs?
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Is your current implementation solution (for FHIR® data modernization or CMS compliance) treated as a ‘software purchase’, or have you established a cross-functional governance model that includes stakeholders from outside the IT department?
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Does your technical team have structured, hands-on training in large-scale FHIR implementations, Clinical Quality Language (CQL), Da Vinci IGs (if applicable) and other experience required to build their own knowledge and quality intelligence layer, or are you dependent on proprietary vendor logic?
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Are you able to build upon the effort and investment on recent modernization initiatives without significant re-work to solve for other use-cases, or is the value of your investment isolated to the initial use-case?
Intelligent Modernization at Scale
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Does your roadmap support phased modernization while minimizing operational disruption?
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Are clinical quality rules, disease definitions, and/or medical policies currently codified once into a unified "reset resource" shared across your whole organization, or are they being recreated manually for different departments, and uses?
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Can your architecture support future analytical and interoperability workloads beyond current compliance requirements?
External Stakeholder Coordination
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Are external stakeholders included, for example payers, providers, delegates, utilization management systems and third party vendors?
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Have you included time for change management, improvements and process refinements with external stakeholders in your roadmap?
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For the January 1st 2027 CMS-0057 deadline, does your team have a documented, sequenced implementation plan for automating prior authorization workflows between payers, delegates and providers that has been validated and piloted by standards experts?
Technology alone does not deliver consistent, scalable modernization.
Align your technical, operational, and external stakeholders to ensure you modernization initiatives are sustainable and provide meaningful outcomes.