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Franciscan Health’s Christian Says AI Spend Stays Unpredictable Until the Bill Arrives

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Franciscan Health’s Christian Says AI Spend Stays Unpredictable Until the Bill Arrives

Franciscan Health CTO Chuck Christian details the cost analyst role he created, the chargeback question, and the outside agent traffic he worries could strain health system infrastructure. Watch below or on YouTube.

The cost controls that made cloud consumption predictable do not transfer to AI. Chuck Christian, VP of Technology/CTO at Franciscan Health, can price a new cloud workload to the month before it moves. Yet he has no comparable way to price an agent. He said so on a recent episode of the healthsystemCIO Show.

Franciscan runs 11 hospitals in Indiana, Christian said, plus roughly 350 practices, imaging centers and urgent care sites. Its Illinois hospital moved to Prime Healthcare in 2026. In addition, the system now runs on Azure, and most of its AI sits on the clinical side, inside the EHR. Microsoft supplies detailed cloud consumption reporting. For AI, however, Christian said Microsoft had to build a separate portal.

In 2023, as the Epic move to Azure came into view, Christian created a Cloud Cost Analyst position and filled it with a detail-driven business analyst. Every Wednesday at 7:30 a.m., a report reaches his inbox with spend to date and projected spend for the month, against budget.

The analyst also hunts for workloads on the wrong hardware. A server running at 5% or 15% utilization is a server Franciscan does not need, and he wants utilization over 50% to 60%, where the machine works instead of idles. Moving a set of workloads onto a server type designed for them will save about $50,000 a month, Christian said.


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