Facing IT Budget Pressure? Start Here...

Many healthcare organizations are facing significant revenue or bottom-line losses in 2022. If you work in healthcare IT, you may be asked to suspend projects, pause on refilling vacant positions or reduce your operational budget. These pressure can be challenging at best. Pausing or shutting down active projects can demoralize staff who’ve worked for months to deliver a result. A paused project can be expensive in terms of sunk costs that won't be utilized and can't be recovered. Not refilling vacancies can negatively impact both the work of the department and the morale of staff. The perception (or reality) of additional work can impact how staff feel about their jobs and the organization. Critical skills gaps may go unfilled, creating various types of organizational risks including cybersecurity and operational risk.

All is not lost. There are some bright spots tucked into the dark clouds. Technology is integral to healthcare and it has to be funded at adequate levels to maintain or improve the services the organization provides. Organizations may have to scale back or reduce budgets, but you can be an active participant in that discussion. More important, one of the best things you can do when you’re facing these kinds of pressures is to take a look at the organization’s technical debt.

It’s possible you can’t reduce your operational expenses at this point in the year. It’s also possible you have to fill a few key vacancies, despite financial pressures. What you can do is look to maximize the use of every technology you already own and reduce/ eliminate/ decommission all technology that’s not being used or that’s redundant. That's your technical debt and like any debt, paying it down generates savings. Reducing technical debt is like organizing your pens and pencils by throwing out all the nubs, the ones missing erasers, and all the pens with no ink left in them. or that have dried up because they've been sitting unused at the back of the messy desk drawer.

Deputize Technical Debt Detectives

One way to do identify technical debt is to engage the whole organization in a bit of a treasure hunt. Toss out a challenge for the best Technical Debt Detective. Deputize the whole organization. Gamify it, create teams, challenge everyone to call out technology they think isn’t being fully used or isn’t being used at all. Challenge your IT teams to identify obsolete or redundant systems.

I did this in a very limited manner last year at my organization and was pleasantly surprised by how many great suggestions people came up with from all across the organization. It’s a great way to engage the organization and bring awareness to under-utilized systems. Other than specific IT applications, most applications were implemented to fulfill some sort of organizational requirement. If that requirement has changed or stopped, there’s a good chance the associated technology was just left out there without an owner. It’s taking up licensing dollars, storage and server capacity, and staff time to manage it (hopefully it is still being actively managed). It might also be creating a serious cybersecurity risk just by sitting idly on some server not really being managed or monitored.

Shutting down these systems not only is smart from a cybersecurity perspective, but efficient since your staff will appreciate not having to manage (patch, update, backup) unused applications and associated data. Just like cleaning up a junk drawer, you’ll have a much better view of what you actually do have once the clean up is complete.

What should also result from this effort is a thorough inventory of every IT application the organization has, where it's hosted, who's the operational owner, who's the IT owner, how current and patched it is, how it's backed up, what the recovery plan is, and what it's function/use is. If this sounds familiar, it is. It's the start of a Business Impact Analysis (BIA), which is a necessary input to any Business Continuity Plan. As the saying goes, never waste a good crisis. If you embark on a technical debt reduction program, leverage every aspect of it.

Respond To Every Suggestion

Be prepared for an onslaught of ideas that you’ll have to review and respond to. Some will be good, some you'll think are silly or just completely missing the mark. That's OK. The point is people are engaged and it's a great opportunity to provide guidance and feedback. Be sure to respond to every suggestion even if the response is “Thanks, that’s a great idea, we’ll put on the list of things to look at in the future.” If someone's way off base, provide that feedback. For example, "Thanks for the suggestion to shut down X, we do want to turn off systems no longer being used. Our [insert team] actually uses this application to provide [insert here]. So, for now, we'll keep it running, but thanks for the suggestion." Also be prepared to take action. Decommissioning a software application can be challenging – you’ll need operational buy-in for archiving the data or agreement to shut down unused (or barely used) servers, storage, and applications. However, if you stand to save money or staff time by doing so, you’ll be able to gain executive support.

Clean Up IT First

Actively reducing technical debt, especially IT-facing systems, helps clean up your IT environment and shows you’re a team player by looking for reasonable ways to reduce IT costs when everyone's budgets are tight. Are you using four different logging applications and not really reviewing the log files they create? That generates more organizational risk than not having them at all. If you're going to capture data, review it through human efforts or automation. Are the solutions redundant (meaning monitoring the same data)? Shut one down. Reduce, streamline, simplify. It lowers costs, lowers human effort, reduces risk and positions you to be able to move forward with a cleaner environment once funding becomes available or the business begins to implement new initiatives.