How a regional healthcare network restructured its application portfolio, eliminated unnecessary tools, and found clarity in 90 days.
Our client was a regional healthcare network with 14 hospitals and clinical facilities, approximately 8,000 employees, and a notoriously fragmented IT portfolio accumulated over a decade of departmental purchasing, acquisitions, and expired vendor relationships nobody ever closed.
By the time they engaged APM Guru, they were managing 142 distinct applications — from mission-critical EHR systems to abandoned clinical trial tools being maintained purely out of inertia. Annual software spend had grown 22% year-over-year for three consecutive years. The IT team had no inventory system. Nobody knew what they were actually running.
The CIO's mandate was clear: get visibility, reduce complexity, and cut the software budget — without touching anything that affected patient care.
Shadow IT was extensive. Departments had procured tools on departmental credit cards that IT had no visibility into. Manually identifying every running application took three weeks.
The primary EHR platform had 23 integrated modules and 14 third-party connectors. Any change had the potential to break clinical workflows. This required clinical stakeholder validation at every decision point.
Every application had a departmental owner who was convinced their tool was unique and essential. Managing the rationalization decision process without creating political battles required careful stakeholder engagement design.
Several applications handled PHI with unclear compliance documentation. Before retiring them, we had to verify data residency, confirm proper data destruction, and document the audit trail for HIPAA purposes.
We deployed automated discovery tooling across the network to identify every running application, integration, and data flow. This was supplemented with department-by-department interviews to capture tools that weren't network-accessible. Final inventory: 142 distinct applications, 23% more than IT believed they were running.
We integrated with the identity provider and SSO system to pull 6 months of login data — giving us real active user counts rather than licensed seat counts. Every application was scored across business value, technical health, usage, and cost. 41 applications were flagged for immediate retirement review based on near-zero usage and direct cost equivalents.
We presented the scoring matrix to 14 department heads in structured review sessions — not one big meeting. Each session covered only the applications relevant to that department. The format made decisions concrete and removed the "but we might need it" objections by anchoring discussions to data. 56 applications approved for retirement. 6 for merger into existing platforms. 24 for license right-sizing.
We managed retirement sequencing, contract terminations, and data migration for the 56 retired applications. For the 24 right-sizing opportunities, we supported vendor negotiations at renewal — in most cases reducing per-seat costs by 15-25% due to reduced volume and our benchmarking data. First savings were realized at Day 90 when 12 contracts were cancelled ahead of renewal.
APM Guru gave us something our team had tried to build for three years — a clear picture of what we actually needed, a defensible process for making hard decisions, and a roadmap that led to real dollars back in the budget.
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