Enterprise agility starts with reducing fragmentation

Ryan Shepherd, EVP, Care Alliance, GE HealthCare

There are four interconnected pressures shaping health system strategy: precision and preventive care, workforce strain, access demands, and financial pressure.

How do you respond to all of them without falling into silos?

When these pressures collide, fragmentation within the health system itself can become one of the biggest barriers to enterprise agility, the ability to move quickly, and act as one.

Internal complexity is becoming a real—and often hidden—cost

Health systems are used to managing pressure. What feels different now is how much these pressures collide. Organizations are being asked to preserve flexibility, protect margins, fund transformation, and improve performance at the same time. 

With all those demands, operating in silos frequently leads to an expensive, direct barrier to flexibility, modernization, and sustainable performance. This can show up in ad hoc capital planning, transactional vendor relationships, inconsistent operating models and data management, as well as stop-start efforts to create capacity and efficiencies across the enterprise.

Enterprise agility depends on how effectively organizations integrate strategy, operations, and execution through a cohesive enterprise operating model.

Capital, workforce, and asset decisions are no longer separate

In imaging, many health systems are managing aging equipment, fragmented vendor ecosystems, and underutilized capacity. It’s not unusual for as much as 30 percent of equipment to be more than 10 years old, with nearly 1 in 2 assets operating well beyond their intended lifecycle, driving annual maintenance costs up by about 25 percent².

And it’s not just equipment. Many organizations are also dealing with aging infrastructure, with facilities that haven’t kept pace with the demands of modern care delivery. The average age of hospital plant assets reached 13.2 years in 2024¹, signaling continued deferred maintenance pressure. 

The challenge is that these pressures don’t exist in isolation. Investments in infrastructure, technology, and workforce need to move together. Simply replacing or adding more technology isn’t the answer, especially when workforce capacity ultimately determines how much value those investments actually deliver. 

What’s needed is a more coordinated approach: investing in capabilities that support long-term scalability, create clearer upgrade paths, reduce complexity, accelerate decision-making, and ease the burden on already strained teams. 

Together, capital planning, technology strategy, and workforce strategy shape far more than infrastructure decisions. They influence access, clinical capability, operational resilience, and financial sustainability.

Operational and data fragmentation create hidden drag

Many health systems are managing highly fragmented vendor environments—some are managing more than 40 vendors in imaging alone, versus a national average closer to 20.²

That level of fragmentation across fleets and vendor environments often creates hidden drag across the enterprise. It shows up as more variation, greater coordination burden, less visibility, and less ability to standardize around a common operating model. 

Underutilized capacity can be another source of drag. When assets, workflows, staffing models, and scheduling practices are not aligned, organizations can struggle to translate available resources into reliable throughput and timely patient access. What appears to be an asset problem in one part of the organization may become an operating issue across the system.

Data fragmentation creates a parallel challenge. When information is spread across systems, settings, and workflows, it takes longer to make decisions—often with incomplete visibility—making coordinated care harder to deliver at scale. Like asset and operating fragmentation, data fragmentation can limit an organization’s ability to act as one enterprise.

Resilience and agility depend on connecting people, process and technology

Organizations that integrate are better positioned to succeed. That’s because resilience and agility depend less on absorbing external pressure and more on reducing fragmentation and responding as one coordinated system.

Organizations making the most progress are building that capability deliberately, supported by clear governance models: reducing unnecessary variation; aligning long-term capital planning, workforce strategy, operating model redesign, and technology deployment; and managing capacity and growth through a coherent enterprise model rather than by site or business unit.

This is not work health systems should have to carry alone. Sustaining this level of coordination requires a clear structure for shared accountability, governance, and long-term alignment. That’s the thinking behind Care Alliances: helping health systems coordinate transformation more deliberately, with a model that complements internal capabilities, eases the burden of enterprise coordination, and supports measurable progress over time. 

As consolidation increases, this kind of enterprise-wide coordination will matter even more 

Scale alone doesn’t necessarily create advantage. It can also introduce more complexity, more variation, and more points of disconnect across strategy, operations, and execution. 

The health systems I see making the most progress are reducing fragmentation by aligning people, process, and technology. In doing so, they unlock greater value from existing technology, increase the return on new investments, and strengthen their ability to act as one enterprise and one team—delivering more value for both staff and patients. 

Ryan Shepherd | LinkedIn

Continue your reading : 

• Explore how Care Alliances support and accelerate enterprise alignment
• Four pressures redefining health system strategy by Ryan Shepherd, EVP, Care Alliance, GE HealthCare
• Navigating Complexity—The hidden costs of adopting healthcare technologies at scale
• The Power of Integration—How connected people, processes, and technology unlock new value for health systems  

References  

1. “Capital Spending Gap Widens Between Large, Small Hospitals,” Becker’s Hospital Review, accessed April 27, 2026, https://www.beckershospitalreview.com/hospital-transactions-and-valuation/capital-spending-gap-widens-between-large-small-hospitals/.
2. “Hidden challenges of integrating healthcare technology at scale,” GE HealthCare, accessed April 30, 2026 https://www.gehealthcare.com/en-us/insights/article/hidden-challenges-of-integrating-healthcare-technology-at-scale