<![CDATA[Effective financial governance is essential for sustaining Hospital Management Information Systems (HMIS), particularly in aligning technology investments with organizational priorities. This study aimed to evaluate the capability level of HMIS budget and cost management at Hospital X in Banyuwangi using COBIT 2019 APO06 – Managed Budget and Costs and formulate improvement recommendations based on identified governance gaps. An evaluative qualitative approach was employed from April to August 2026, involving four purposively selected key informants representing hospital management, financial administration, accounting, and HMIS management. Data were collected through semi-structured interviews, observations, and document reviews, followed by source and method triangulation and evidence mapping against five APO06 management practices. The findings indicated that HMIS financial governance was at Capability Level 1, compared with the target of Level 3, resulting in a two-level capability gap. Although basic financial administration and annual budgeting procedures had been implemented, HMIS expenditure was not specifically classified, resource allocation remained predominantly reactive, budgeting was insufficiently integrated with system development planning, and systematic cost allocation and expenditure monitoring mechanisms were lacking. These findings demonstrate that existing financial procedures have not been adequately integrated into HMIS-specific governance. Recommended improvements include establishing HMIS-specific cost classifications, formalizing investment prioritization, integrating development plans into annual budgeting, implementing phased cost allocation, and strengthening budget realization monitoring and corrective actions. The study concludes that progressive improvements in APO06 practices are necessary to strengthen financial transparency, accountability, and evidence-based investment decisions while supporting sustainable HMIS development.]]>
