Why Hospital CIOs Must Rethink IT Architecture — 10 Missing Links in the Hospital IT Operating Model 💲
- Sunil Dutt Jha
- 3 days ago
- 5 min read
Updated: 2 days ago
CIO Diagnostic Series — Hospital Edition
Why Hospital IT Looks Anatomical — But Isn’t
From the outside, most hospital IT estates look modern. EMR/EHR is live. LIS and RIS integrate cleanly. PACS imaging works. Pharmacy is digitized. Billing and claims engines operate. Patient portals are functional. Cloud and analytics initiatives are ongoing.
On paper, here’s what typically exists:
EMR/EHR for clinical documentation
Laboratory Information Systems (LIS)
Radiology, RIS & PACS
Pharmacy & medication management
Admissions, discharge & bed management (ADT)
Billing, insurance & claims processing
ERP for HR, finance, procurement & materials
OT, ICU, ventilator & bedside device integrations
Patient apps, call centers & communication channels
Cloud modernization & data engineering programs
Analytics, AI dashboards & quality reporting
HL7, FHIR, DICOM interoperability
Yet — hospital operations keep breaking.
Medication orders stall. Discharge paperwork delays billing. Insurance approvals slow treatment. ICU vitals integrate — but don’t trigger escalation. Radiology results don’t update care plans. Bed availability looks accurate — until admission fails. Patient complaints rise despite digitization.
Infrastructure grows — but predictability does not.
Despite significant investment, hospital execution remains fragile.
Why?
Because hospitals automated systems — not clinical pathways. Processes were digitized — not modeled across departments. Rules exist — but are scattered and invisible. Modernization upgraded tools — not enterprise coherence.
Even inside IT, the actual Enterprise Architecture of a hospital was never built.
And that’s why:
EMR, LIS, PACS, pharmacy & billing work — but not together
Every change produces unexpected operational side effects
ER, ICU, wards & OPD run on different logic
Escalation depends on clinical memory, not systems
Projects deliver — but patient flow doesn't improve
Exceptions become the operating model
Hospitals spend heavily — but without enterprise anatomy, outcomes drift.
One Healthcare Enterprise, One Anatomy™ — The True Structure
According to the ICMG Enterprise Anatomy™ model, a hospital operates across 15 essential functions:
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