Health system CIO agenda holds the keys to disrupting and rebuilding care delivery

Care delivery in the US and globally is undergoing a significant shift. In the US, the future of health systems will see significant consolidation driven not only by the need to survive and thrive as a business but also due to a once-in-a-lifetime demographic shift. For the first time in US history, the country will see more older than younger people in 2034. Health systems must embrace reimagined care delivery paradigms, especially as the country is predicted to face a shortage of over 80,000 clinicians by 2030.

Health systems have traditionally been a laggard with technology adoption, which is a blessing in disguise. Their low level of tech debt can aid in rapid modernization while balancing the need to strengthen their defenses against the increasing threats posed by malicious actors. These unprecedented headwinds must drive the CIO agenda (see Exhibit 1). Health systems will require a new generation of CIOs who are technocrats possessing deep healthcare expertise and a generous dose of courage and imagination to execute solutions.

Exhibit 1: Health system CIO agenda must balance four critical business drivers

Source: HFS Research, 2025

A. Health system CIOs must lead the development and execution of a new operating playbook

Health systems saw a 50% consolidation between 2017 and 2022, decreasing from approximately 600 systems to around 400. Given the trajectory of mergers and acquisition (M&A) activities in the post-COVID-19 period (see Exhibit 2), consolidations will likely increase.

Exhibit 2: The last decade shows a distinct bias for M&A activities slowed only by a pandemic but picking right back up

Source: Kaufmann, Hall and Associates, HFS Research, 2025

A recent HFS Research study found that a large part of the industry’s consolidation is driven by health systems’ growth aspirations (improved reimbursement terms), survival (escalating costs), and positioning to capitalize on the future of care delivery. These drivers are challenging and will continue to energize M&A activities, at the very least, through the end of the decade.

The consolidation-driven profile of future health systems will have tens of thousands of beds across multiple cities, in multiple states (and countries), and will be deployed through many hospitals. Their complex portfolio of specializations (oncology, cardiology, neurology), services (ambulatory, acute care, imaging, pharmacy), and markets (direct to employers, Medicare, international) must optimized. Health systems must develop a new operating playbook to reimagine the future of a larger cross-border footprint, optimize a complex portfolio, and fully realize the benefits of consolidation.

Consequently, the CIO agenda must align and support the new enterprise playbook, which will include post-merger integration (organization, culture, processes), rationalization (facilities, resources, operations), future-proof infrastructure investments (hospital-at-home), security (cyber), and innovation (emerging tech, new business models). CIOs must go beyond tactical outsourcing and embrace a strategic and diverse ecosystem. They have an opportunity to create a future-facing technology-enabled business organization that will form the spine of the health system for times to come.

B. CIOs must build tech that delivers on both health and care

The demographic shift means that the systems must also lean into health, not just traditional care delivery, to ensure the volume of business is not exclusive to the sick. The technology needs of the healthy will be wellness-focused (fitness trackers, meditation app), while those of the ill will support disease management (remote monitoring, imaging). As health system CXOs prioritize and embrace technologies beyond electronic health records (EHRs) as a driver to address the changing market demands and the future of care delivery (see Exhibit 3). CIOs must lead the journey to business value realization, not just be the implementers of new gizmos.

Exhibit 3: Health system priorities to navigate the future cannot afford CIOs to play catchup

Sample: 152 health system CXO
Source: HFS Research, 2025

Overall, the population across demographics is increasingly dependent upon healthcare technologies with wearables, ambient tech, and telemedicine. Various estimates peg more than 50% of US consumers actively use wearables, and a similar number have used telemedicine. In this context, CIOs must strategically enable the collection of real-world data, analytics, and dissemination for clinical decisions and disease management. They must lead the efforts to drive whole-person health, which will be critical to health system economics and consumer health outcomes.

COVID-19 has shown hospitals and care facilities the impact of sub-optimal supply chains, which led to shortages of critical medications and supplies. CIOs must take the lead by reimagining and developing a future-proof supply chain tech stack, just as they prepare for hospital-at-home, enhanced telehealth, and other innovations in care delivery.

C. Life or death is not hyperbole with the significant proliferation of bad actors in healthcare

According to the Department of Health and Human Service’s Office of Civil Rights, there were 367 reports of cyber-attacks from healthcare providers impacting over 38 million consumers, a 300% increase from 2023. To make matters more interesting, each acute care bed has anywhere from 10 to 20 Wi-Fi-enabled devices connected to it. While the positive possibilities of IoT in healthcare are extraordinary, it has also elevated healthcare to being the second most vulnerable industry at risk of cyber-attacks that directly impact life or death.

CIOs must have cyber security at the center of their agenda and tight integration with the chief information security officer’s (CISO) agenda. This translates at a basic level into compliance with regulations, achieving critical certifications such as HITRUST, and, at the highest level, staying ahead of bad actors by making the proper infrastructure, training, and process investments. Collaborating with the CISO and prioritizing security should always be at the head of the class.

D. The future of care demands a radically new tech stack

The future of care delivery is an evolving target. However, there are some critical and definite drivers to drive thought leadership: a) a rapidly aging society, b) a critical shortage of clinicians and caregivers, and c) an enormous proliferation of technologies. The drivers suggest a different approach to care delivery, using clinical resources when needed instead of when wanted, moving away from traditional hospital settings.

Hospital-at-home will likely be a key strategy for providing patients with better health outcomes, addressing costs, and enhancing their experience.  CMS has been supportive, and health systems such as Johns Hopkins have invested and experimented with it. CIOs must make room to accelerate and scale such innovations to help differentiate, address patient demands, and meet corporate objectives.

Another innovation that needs CIO attention is the paradigm shift, which is need-based instead of demand-based. Technology can predict consumers’ wellness by leveraging various consumer health data (see Exhibit 4). Clinical intervention will be triggered only when personalized thresholds are breached, e.g., A1C level spikes for a 65-year-old male stay about 170 for over 2 hours. This shift leverages contemporary technologies augmented with AI-enabled clinical decisions to optimize clinical resources.

Exhibit 4: The demand-based care delivery must be augmented at scale with need-based care delivery for us to survive the future

Source: HFS Research, 2025

The Bottom Line: Healthcare system CIOs must shift from tech implementers to business architects or risk being outpaced by competitors and overwhelmed by demographic headwinds.

The sheer breadth and complexity of headwinds that health systems are facing will require the CIO agenda to uber-balance the needs of the current with the future, execute tactically while planning strategically, bring to bear the best technology, and wear an astute business hat. There is no room for missteps for a health system CIO in an industry that truly drives life and death.