Download the 2026–2027 Trustees’ Health IT Decision‑Making, Funding & Governance Manual
How‑To” for Directors, Trustees, and Executives — Gratis to Board Members
New from Black Book Research Insights: Black Book Boardroom Playbook: 2026–2027 Health IT Approvals — a plain‑English field manual that lets Boards govern hospital and health‑system technology with confidence: clear decision rights, a 90‑day proof‑of‑value (PoV) standard, a board scorecard you can read in minutes, and vendor‑neutral guardrails that keep approvals independent of CIO or seller influence.
Why this manual — why now
Hospitals are moving from pilots to disciplined scale. In 2026–2027, Boards will be pressed to fund modernization across access, automation, cybersecurity, and interoperability — with real dollars at stake. Peer signals in the report show trustees expect to approve a defined set of “big ticket” items (e.g., trust & cybersecurity uplift; patient access and contact‑center automation; event‑driven EHR writebacks; AI documentation assist), and to phase 5–7 initiatives in Year 1 while holding the rest for 2027. The manual gives trustees independent standards, not sales decks: proof before purchase, portability before dependence, and value you can audit. (See Board Executive Summary and “Top 20 Large IT Purchases Boards Will Be Pressed to Fund,” pp. 4–15.)
What you’ll get
- The Trustee’s Five‑Question Governance Lens: One‑page proposals that answer: outcomes, evidence, safety & trust, portability, and total value — so the Board can decide without becoming technical.
- 90‑Day PoV Standard (not a “pilot”): A time‑boxed contract with baselines, Day‑90 targets, named owners, and pass/fail gates
- Top 20 Big Purchases for 2026–2027 — with budget bands: What boards will be asked to fund, which hospitals it affects most, and suggested budget percentages to plan — plus 20 often‑missed enabling purchases (consent management, PAM, immutable backups, API security, FinOps) that reduce risk and speed later wins.
- Quarterly Oversight Routine & Scorecard: A 15–20 minute board segment that reviews five pillars — Automation & Access; Interoperability & Reliability (SRE); Value‑Based & Revenue Integrity; Governance & Trust; Cost Discipline — with RAG indicators, owners, and motions.
- Guardrails & Ethics you can enforce: “No artifact, no approval.” Live event→writeback proof, PHI/model‑use boundaries, export+reload drills, outcome‑linked fees, equity monitoring, and whistleblower pathways.
- Financial oversight that travels with the CIO/CFO: Benefits ledger, service‑spend caps, CapEx/OpEx/“evergreen” clarity, and a standing PoV fund to keep experiments small and auditable.
- Case scenarios & trustee scripts: Board‑ready language for AI documentation, interoperability, vendor renewals, automation equity, outages, and predictive tools.
- Ready‑to‑use templates & checklists: PoV Charter, Quarterly Scorecard, Annual Trustee Checklist, Vendor Integrity Checklist, AI ethics checks, ROI ledger, education log, and a maturity roadmap.
Who it’s for
Hospital and health‑system Boards of Trustees, CEOs/Administrators, CFOs, COOs, and service‑line leaders — including long‑tenured and first‑time trustees who want a repeatable, vendor‑neutral approval process that separates governance from technology selection and restores fiduciary control to the Board.
Clear executive moves for the next 90 days
- Adopt the five‑question one‑pager as the entry ticket for any IT request.
- Charter 2–3 PoVs with Day‑90 targets and named owners; schedule scale/fix/stop motions now.
- Run an export+reload (portability) drill for one live system (≤14 days).
- Launch the board scorecard (five pillars; RAG; variance notes).
- Stand up the benefits ledger and cap services spend relative to realized benefit.
Three non‑negotiables when vendors lead with “pilots”
- Live, event‑driven read/write proof in your environment — not demo theater.
- Change‑control & version resilience with your right to independent validation.
- No‑fee portability with export+reload verified before scale. (Vendor governance checklist.)
Board dashboard categories to review quarterly
- Automation & Access: queue time, abandonment, auto‑resolve %
- Interoperability & Reliability (SRE): % workflows with writebacks, P95 latency
- Value‑Based & Revenue Integrity: denial rates, gap closure, RAF accuracy
- Vendor Pack (RFP + Due DiligenceGovernance & Trust: DPIAs, audit logs, export drill timing
- Cost Discipline: services cost as % of benefit, variance vs. plan (See “The Board’s Quarterly Oversight Routine and Scorecard System,” pp. 34–37.)
Evidence Pack (minimum per approval)
PoV charter; baselines & Day‑90 results; safety & equity exceptions; PHI/model‑use policy; audit logs; portability report; SOC 2/HITRUST/DPIA evidence; vendor change‑control; and board minutes for gate decisions.
Appendices you can use immediately
- PoV Charter template & Quarterly Scorecard
- Annual Trustee Oversight Checklist & Benefits Ledger
- Vendor Integrity & AI Ethics checklists
- Maturity roadmap, meeting calendar, and trustee education log
Independent. Actionable. Vendor‑neutral.
This gratis resource translates board obligations into an approvals system your teams can run: proof over promises, evidence over anecdotes, exit‑ready by design. (“Guardrail Principle: evidence and auditability — not relationships — determine the vote,” Board Executive Summary.)
About the research
The manual draws on Black Book’s Trustee Digital Governance & IT Purchasing Outlook pulse — verified responses from 370 trustees across 313 hospitals in 35 states — and distills peer‑tested funding allocations, stage‑gates, and artifacts for 2026–2027 approvals. It also summarizes typical budget impact (≈12% if all ten core initiatives are adopted; most boards phase 5–7 projects in Year 1) and the quarterly phasing pattern used by high‑performing systems.
Black Book Market Research
Make digital decisions predictable and auditable. From the boardroom to the bedside, this manual equips trustees with the controls, artifacts, and motions to scale what works — safely , ethically, and with ROI you can verify.
Contact: research@blackbookmarketresearch.com for more information.