How a Hospital Mistook 180 IT Project Completions for Enterprise Architecture 💲

Part of the Healthcare Enterprise Anatomy Diagnostic Series

1. How This Pattern Emerged

Over the last two years, ICMG has reviewed transformation portfolios across major hospitals and provider networks — from academic medical centers to regional community hospitals.

These institutions ran programs in electronic health records, patient portals, telehealth, billing, claims, lab integration, imaging, and cybersecurity. Some had 300+ engineers assigned to “digital health” programs. Others ran hybrid in-house/vendor delivery across multiple states.

But across every site, one pattern held true:

Projects were delivered. Systems were modernized. But the hospital was never modeled structurally.

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