Governance is driving digital health maturity even more than budget

After years of heavy investment in technology adoption, the healthcare industry is finding that success isn’t about how much you spend, but how well you govern what you have. 

The 2025 Digital Health Most Wired National Trends Report from the College of Healthcare Information Management Executives (CHIME) reveals that healthcare organizations with strong governance structures, dedicated executive leadership, and disciplined measurement practices consistently outperform peers with similar or even larger technology budgets.  

The report, based on data from 270 organizations worldwide, shows a sector maturing beyond the “adoption” phase and into an era defined by governance, integration, and measurable results. 

Higher spending on IT or cybersecurity doesn’t necessarily lead to higher performance, the report finds. Instead, the most advanced organizations are those that link digital investment to strategic goals and clear accountability.

“Effectiveness per dollar matters more than total spending,” the report notes. Hospitals that track ROI at the program level, engage executive boards, and maintain focused governance structures consistently outperform those that spread budgets thin across siloed initiatives. 

In other words, focus beats funding. 

Across the survey’s eight domains, spanning infrastructure, cybersecurity, analytics, and patient engagement, one pattern remained consistent: digital excellence depends as much on leadership as on technology. 

Governance, not gadgets, defines digital leadership

Nearly three-quarters of organizations surveyed now maintain a formal digital governance committee, and more than 60% review digital performance metrics quarterly with executives. Those that embed cross-functional oversight into their culture, like linking IT strategy to clinical quality and safety, demonstrate significantly higher levels of digital maturity. 

This shift toward structured accountability is mirrored in how organizations handle data. The majority (62%) have adopted enterprise data governance frameworks, and nearly half (42%) now monitor data quality across their organizations. Yet only a third have extended those standards to data received from external partners—a critical gap as interoperability expands. 

Integration as the new currency

The report makes clear that connectivity—not capital—is what separates leaders from laggards.
Hospitals that integrate clinical, administrative, and supply chain data show stronger outcomes across patient safety, cost control, and workforce efficiency. About two-thirds of respondents have achieved at least partial integration, while one-third report real-time synchronization across departments. 

That connectivity extends beyond internal systems. More than 90% of respondents participate in at least one health information exchange (HIE) or FHIR-based network, and roughly two-thirds maintain longitudinal patient records that integrate data from multiple sources, from EHRs to community health and payer data. 

Still, the next step—turning those data flows into actionable insight—remains uneven. Only half of organizations use longitudinal data for real-time risk identification or predictive analytics, suggesting that interoperability’s potential is still being realized. 

Cybersecurity compliance meets company culture

Cybersecurity remains healthcare’s top digital priority, but the focus is evolving. Nearly all organizations now maintain 24/7 threat monitoring and advanced endpoint protection, yet fewer than half have automated threat response capabilities.
The survey found that quarterly or semiannual incident-response testing is a key differentiator of digital maturity. High-performing systems treat these exercises like emergency drills—measuring detection and recovery times, refining playbooks, and aligning cybersecurity with enterprise risk management. 

Board engagement is also rising. Eighty-five percent of organizations now brief their boards on cybersecurity at least annually, and almost half do so quarterly. 

Scaling AI

While 98% of organizations have integrated AI into some aspect of care or business operations, nearly all also report “material barriers” such as data quality, workforce readiness, and governance gaps. 

The most mature organizations (95%) tie AI investments to tracked outcomes or ROI, and a similar share report model validation and bias monitoring. Yet post-deployment governance remains inconsistent; less than half of respondents conduct ongoing model audits or bias testing after AI goes live. 

Measuring sustainability and equity

This year’s report adds new emphasis on climate resilience and health equity. Nearly all organizations have adopted sustainable procurement policies, but only about 40% measure energy or carbon impact within their IT operations. 

Similarly, while digital engagement tools—like portals and telehealth platforms—are now ubiquitous, accessibility remains uneven. Just half of organizations offer multilingual interfaces or track usage disparities by age, literacy, or income level.  

For healthcare IT leaders navigating constrained budgets, workforce challenges, and accelerating technological change, these findings offer both validation and direction. You don’t need more resources than your peers, you need to use your resources more strategically.