Health organisations across Australia and New Zealand are seeing SaaS costs rise quickly while application duplication quietly expands across teams. Tools are often adopted to solve local problems, then become embedded, renewed and replicated elsewhere. Over time, this leads to overlapping capability, inconsistent controls and contracts negotiated without clear usage evidence.
This is happening as health leaders are asked to deliver three outcomes at once: reduce costs, reduce risk and improve efficiency, all while modernising ageing systems and supporting new models of care.
The challenge is that most technology environments have grown organically. Legacy infrastructure sits alongside SaaS applications and cloud services, often purchased and managed across multiple teams. Without a trusted, unified view of what exists across the estate—what’s used, what it costs, who owns it and where risk sits—governance fragments and investment decisions slow.
Public reporting on major digital programmes reinforces the point. When cost and integration complexity aren’t fully visible, delivery risk increases. In New South Wales, reporting on the Single Digital Patient Record raised concerns that the business case didn’t capture all relevant costs or consider legacy integration, increasing the risk of overruns and misinformed decisions.
What does the visibility gap look like in practice? Three common examples appear repeatedly in large health environments.
Healthcare SaaS sprawl crates hidden cost and governance risks
First, SaaS sprawl rarely starts as a governance issue. It usually begins with teams trying to move faster. Over time, however, duplicated tools, overlapping contracts and renewals negotiated without clear usage evidence become common.
A practical first step is the one health IT leaders increasingly recommend: Catalogue tools by owner, usage, cost and overlap, then consolidate based on outcomes and evidence.
When organisations can see which applications are used, by whom and where, they can reduce unnecessary renewals, standardise where it makes sense and strengthen controls around unapproved applications. This shifts teams from reactive true-ups and firefighting to proactive portfolio governance.
Healthcare cloud costs are difficult to control
Secondly, cloud has become one of the fastest-growing lines in technology budgets, particularly as data, analytics and AI workloads scale. Cloud costs are variable, granular and often provisioned by engineering teams, which makes forecasting and accountability harder.
NHS guidance on FinOps describes this shift clearly. Cloud costs are treated as operating expenses, they’re variable and difficult to forecast, and purchasing decisions often sit with engineers provisioning services. This requires new disciplines and tools to optimise spend.
With consistent visibility and allocation, health organisations can set guardrails, improve forecasting and prioritise high-impact optimisation without compromising operational requirements.
Healthcare IT asset management and audit readiness
The final lens is IT asset management (ITAM) and audit readiness. Organisations need to know what hardware and software they have, what’s reaching end of life (EOL) or end of support (EOS) and how quickly they can respond if a major vendor review lands.
When visibility is incomplete, these requests consume scarce specialist time and can create budget shock through rushed true-ups and unplanned remediation. In contrast, reliable reporting and repeatable evidence reduce uncertainty and disruption, protecting time and focus for clinical and operational priorities.
The takeaway: Healthcare organisations need unified IT visibility
Digital health transformation often slows not because strategy is wrong, but because leaders lack a unified view across the estate, especially as SaaS sprawl and cloud consumption accelerate. The practical path forward is platform-level technology visibility that connects:
- IT assets and traditional software governance
- SaaS discovery, usage insight and renewal readiness
- Cloud allocation, governance and optimisation (FinOps)
When visibility scales with complexity, health organisations can reduce waste, strengthen governance and keep transformation moving, so technology enables care rather than constraining it.
