For many hospital and health system executives, the CIO role has shifted over the last several years. Technology leaders are no longer evaluated primarily on uptime, cybersecurity or project delivery; they are increasingly expected to demonstrate how digital strategy contributes directly to enterprise value from workforce efficiency to growth, access and long-term scalability.
This shift is unfolding as margins remain tight and capital constraints as executive teams face mounting pressure to show measurable returns from every major investment. In that environment, hard digital ROI is the expectation. But proving dollar value is harder as health systems become more complex.
At Philadelphia-based Jefferson Health, chief digital and information officer Luis Taveras has been deliberate in how he positions IT within the organization, particularly as the system integrates Allentown, Pa.-based Lehigh Valley Health Network, which was acquired in 2024, and manages rising demand for digital tools.
“From that organization governance standpoint, we’re implementing the process to make sure that we’re making the right investments in the right solutions that are going to bring the biggest value to the organization,” he said. “I don’t think of IT and IS as a cost center, like some people think about it. We are a value center. The organization chooses to invest in the solutions we provide, and we need to bring value back to the organization as a result of that investment.”
For many CIOs, this reframing is essential. As CFOs and CEOs scrutinize technology spend more closely, digital leaders are increasingly expected to articulate value in business terms, such as workforce capacity, operational resilience and scalability, rather than system features or technical milestones.
Governance as a mechanism for ROI
As AI interest accelerates across healthcare, governance will ultimately determine value, not the number of pilots launched. Governance has become a financial discipline as much as a risk control. Clear decision structures help prevent duplicative investments, reduce vendor sprawl and accelerate enterprise adoption once a direction is set. Without that discipline, even well-intentioned innovation can erode ROI.
Governance is foundational work at Jefferson.
“It really starts with creating that strategic plan, and that was the focus of the first three months together and we put together such a plan that defines a very clear journey from where we were at that point, which is really more of a reactive organization, to an operational excellence stage,” said Dr. Taveras. “Then our final journey is getting to be a high performance organization. We are creating that vision over the next five to seven years and building the parts of the plan that say how we’re going to get from here to there. The critical part of that is the governance model, making sure everybody understands how we’re going to evaluate technology that comes our way, especially today with AI.”
Executives teams are bombarded with AI investment opportunities daily and need a process for decision-making. A well-defined process including all stakeholders will yield the best results, with the health system’s mission in mind. Dr. Taveras and his team take any feedback from their colleagues using the technology to heart – satisfying their needs as often as possible. But not every request is possible to fulfill.
“We’re not an IT organization. We’re a healthcare organization, and we’re here to make sure that we provide the best healthcare to our patients and the best service to our members and students that we have,” he said.
Platform discipline over tool sprawl
At Columbia, Md.-based MedStar Health, CIO Scott MacLean is taking a similarly disciplined approach, centered on platform strategy and application rationalization amid an EHR transition. Over the last few years, MedStar has acquired new facilities and focused attention on unifying EHR and tech solutions systemwide.
“The strategy is to use platforms,” Mr. MacLean said. “A lot of people are talking about the EHR, ERP, the collaboration platforms, and making sure that those are implemented as fully as possible.”
Platform-first strategies increasingly serve as a hedge against rising integration costs and operational complexity. Rather than chasing isolated departmental wins, leaders are prioritizing enterprise standardization that can support future growth and advanced capabilities without linear cost increases.
Rather than layering new tools on top of existing structure, MedStar is evaluating every application against what core platforms can already deliver and being ruthless in sunsetting old tech.
“You have to be very disciplined about eliminating and retiring the old systems,” Mr. MacLean said. “Make sure that you’re not in a place where you’re still using things that are confusing for clinicians or patients, and certainly not paying for things that are not in use anymore.”
Workforce impact as measurable value
In the ongoing quest to prove value, workforce impact is emerging as one of the most credible measures of digital ROI. As staffing shortages persist and burnout remains high, technology that returns time to clinicians or reduces cognitive load is increasingly viewed as a strategic asset.
Dr. Taveras and Mr. MacLean both pointed to workforce efficiency and experience as one of the clearest ways digital investments are paying off, particularly as AI accelerates from pilots to scale systemwide. Ambient AI is already reshaping documentation workflows and care team interactions, especially as adoption expands beyond physicians.
“We started deploying ambient in 2025 with the physicians, and we have now moved on to nursing,” Mr. Taveras said. “I think the impact on nursing is going to be equally as large and as impactful as it was for the physicians.”
He said the benefits are both operational and human.
“We’re seeing the nurses be much more efficient in the way they document and we’re seeing the nurses be much more conversant with their patients, which is absolutely critical,” he said.
At MedStar, digital strategy is closely tied to access, patient experience and growth across a large regional footprint. Rather than custom-building solutions, the focus is on configuring platforms around best practices that scale.
“There are a lot of things in the environment that have come along and been very helpful within the core system that we use today, but we’re going through a whole process of evaluating every one of them and deciding whether our new platform can do that function, or at least a great percentage of it,” said Mr. MacLean. “Then we’re respectfully going through and having conversations with the important stakeholders about how our new platforms are going to cover the functionality that they have in existing systems. Then you have to be rigorous about being able to set up and support the new platforms and any integrations that need to take place.”
The new EHR platform will go live in late 2027 and Mr. MacLean is looking for ways to configure the platform so the system is taking advantage of patient preferences. Are patients seeking care and scheduling appointments efficiently? Do they have access to urgent and specialty care? What would make the emergency department experience better?
“With artificial intelligence algorithms that need to be experimented with and proven, we’re looking at taking advantage of that functionality as well as what is provided through our core vendors, but we’ll also have the discussions about supplementary interventions that may not yet be provided by those vendors,” he said.
Increasingly, CIOs are being judged not just on delivery, but on whether digital investments enable the organization to operate differently, with fewer manual steps, greater consistency and more flexibility to adapt.
Digital work only matters when it is clearly tied to enterprise outcomes.
“We enable that to happen,” said Dr. Taveras. “We don’t do IT and technology for technology and IT-sakes. We do it because it means something to the business.”
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