A funny thing happens to a hospital information system over time. Old technology is only partially retired. Since these outmoded, old systems still retain vital data which is difficult to import, they must remain active and cannot be disconnected. In a few years, additional systems are added from different software and hardware vendors. Again, the older programs and hardware can never be fully retired so they continue to run amidst the information infrastructure.
Soon, the information technology contains multiple generations of complexity, all attempting to work in harmony.
In time, the folks who supported the older systems retire or die of old age, but their legacy computer software and hardware live on because they still contain necessary data and act as a key bridge for certain functions.
A few years later, even newer hospital departments add their own special health records software, crudely attached to the main software and hardware systems.
All of this must be accessible remotely, so someone contracts a company to write special code to tie some of the systems together, but they never really work well together and frequently crash each other. The additional code has the perverse effect of integrating the obsolete systems into a vital support beam of the computer infrastructure.
Unplug an older obsolete technology and the whole system collapses.
Meanwhile, old style dictation typists must input their reports, though they are badly converted and assembled with the newer technology. In back rooms, ancient vacuum tube devices continue to glow, supporting long forgotten functions of the master computer.
Before anyone notices, the hospital information complex is now three decades old and no one has a clue how it all works. It becomes a money-eating organism which expands in a modular fashion, gobbling department budgets and occupying more employees.
Someone shouts: “We need to integrate an ACA community health record!” and the massive grinding structure quickly triples in size at enormous cost. The overwhelmed hospital finally declares bankruptcy and sells out to another healthcare entity. The workers and ownership change, but the data-churning monstrosity does not miss a beat as it continues to expand, integrating and absorbing the new owner’s computer system.
It is too late! Nothing can stop it!
Run for your lives!!!!