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Comment by elpakal | Hacker News Reader

I worked at Kaiser IT, and there are definitely some well intentioned IT folk there trying to make revolutionary changes to healthcare. However, the company's internal infrastructure (inventory, expenses etc) is a giant cluster running on deprecated versions of XYZ. At one point we heard the metric that almost half of the inventory they have in hospitals was just lost in the system so they have no idea where it could be. Gets off the truck, scanned in, the inventory system craps out and it's lost forever. I don't know if that was accurate or just the remarks of a crusty manager, but I left after a short time because they definitely made me believe it.

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Most hospitals are running on woefully outdated and/or inadequate technology. I've had a few different friends in healthcare IT and every story has been a nightmare. I'm not sure why it's this way.

Certification.

You CANNOT have bugs in your ventilators, pill dispensers, heart-rate monitors, etc. As such, they are typically only certified on some old version of Windows. As such, they can't be updated, or they have to re-cert that new version of windows. By certification, it goes anywhere from the bugs in the compiler all the way to the EMI interference from a cell-phone that may interact and cause a fault. It can be very intense. Re-doing a cert is an incredible mess. So, they stay on the old version and that makes integrating with all the various versions of mainframes, windows, DOS, UNIX, etc. a total disaster of a task.

In hospitals, most back end IT improvements don't directly drive revenue or care quality. So funding tends to be diverted to other things like new surgery centers, higher resolution MRI machines, nicer patient rooms, free care for the indigent, etc.

This. Backend IT was most definitely a cost center and even more so one that was very poorly run and incentivized to not change. They have a pension program there and there are soo many people who made it and are pensioned that the only incentive they have is to ensure things do not change.

Kaiser could do so much with the data they have and could have. I wish they were more forward looking.

Agreed

That EPIC lock-in, tho.....

Kaiser only started implementing Epic in 2005 and finished in 2010. So any lock in is squarely on their own shoulders.

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