Why the Healthcare Sector Just Can’t Seem to Quit the Legacy Systems Habit


Many hospital systems maintain fragmented administrative, clinical, and regulatory information about medical records compliance and patient data. The Result? $1 trillion is lost in waste every year – that’s a wastage of $1 for every $4 dollar spent by the US on healthcare. The gravest problems pertaining to this travesty arise within the confines of legacy systems. Some of the gravest problems are:

1) The undesired comfort factor of simply maintaining the status quo results in operational silos
2) Hindrance in Integrating with a new system or features
3) Risk aversion mentality
4) Outdated cultural hierarchy resulting in the phenomenon of hero worship

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In its Technology Vision 2021 report, Accenture brands legacy modernization as the creator of “technical wealth.” Indeed, the process of moving from outdated, obsolete applications and operating systems to efficient, agile, scalable systems is critical to the evolution of any enterprise.

This rings true for the healthcare sector, where the reliance on aging and antiquated systems has been well-documented. Risk aversion, budgetary constraints, compliance intricacies, and a lack of forward-facing tech knowledge prevent healthcare institutions from looking beyond the persistent patterns of their operating models.

On the surface, it’s somewhat understandable that healthcare providers would be so reluctant to embrace change. However, as the business landscape evolves, legacy systems become an increasingly expensive liability — an impediment to competitive advantage, growth, and economic prosperity.

And this makes it all the more important to granularly examine the issues associated with legacy systems and what prevents healthcare providers from moving forward with modernization initiatives.

What Problems do Legacy Systems Create in Healthcare Institutions?

Healthcare institutions that fail to look beyond the legacy systems stay trapped in a vicious cycle of cost and productivity overruns. In today’s competitive market, these issues need to be rapidly addressed — or risk severe business distress.

It’s commonly acknowledged that many hospital systems maintain fragmented administrative, clinical, and regulatory information about medical records compliance and patient data. The Result? $1 trillion is lost in waste every year – that’s a wastage of $1 for every $4 dollar spent by the US on healthcare.

The following are some of the gravest problems legacy systems create within healthcare institutions:

The Undesired Comfort Factor & Operational Silos

The comfort factor — the familiarity with the established operational structure and methodologies — creates a sense of complacency. Often, this leads to healthcare providers overlooking the need for transition (or collaboration) and offering out-of-sync products/services.

Margaret McCartney, a general practitioner, labels such a rigid, non-collaborative, and non-dynamic environment a breeding ground for “conflicts.” For instance, she lays out examples of two campaigns running in tandem:

—One that’s focused on limiting “antibiotic prescriptions.”

—And the other that necessitates treating “potential sepsis…with antibiotics.”

Over time such silos are a major stumbling block to the efficient implementation of new enterprise-wide initiatives. They make it difficult for the practitioners and the patients alike to track and respond to the intricacies of specific aspects related to a particular treatment.

In the end, it comes down to the practitioners doing all the heavy lifting. As practitioners, “we have to manage these conflicts every day with our patients…We are calculated risk-takers,” writes McCartney for British Medical Journal.

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Hindrance in Integrating with New System or Features

Before a system or feature can be deployed, it must be integrated into the existing infrastructure. This process involves identifying and mapping the components of the content management system and other data repositories.

However, inherent limitations in legacy systems create retardations in the adoption of the new system(s) or features. Consider the case of telehealth, a convenient and cost-effective alternative, especially in the face of a crisis like the Covid-19 pandemic.

However, much existing interoperability and security constraints prevent the effective adoption of telehealth across the board. Many healthcare institutions do not have the required set-ups in place to allow practitioners to access patient data across multiple devices (or platforms). The lack of patient-facing applications to deliver clinical content and telehealth services leaves a lot to be desired.

So, why do Healthcare Institutions Stick with Legacy Systems?

Based on the mounting evidence, it’s evident that legacy systems hinder healthcare institutions’ growth. Their limiting impact on a business’s bottom line and competitive advantage make them an expensive liability.

So, if the drawbacks associated with legacy systems are so apparent, why do healthcare providers often prefer to flounder with outdated models? Here are some of the most common reasons:

Sunk Cost Fallacy

Sunk cost fallacy refers to the cognitive bias that causes people to consistently place disproportionate value on a decision already made.

In the case of healthcare institutions, the sunk cost fallacy can be particularly detrimental. It drives organizations to remain stuck with their outdated IT infrastructure, even in the face of mounting business challenges and market uncertainties.

Risk Aversion

The cost of a failed attempt to modernize infrastructure is enough to make any company think twice before attempting it again. McKinsey outlines how the success rate of digital initiatives in the traditional industries, including pharmaceuticals and healthcare delivery, languishes in the range of 4% to 11%.

This risk aversion is a constant with legacy IT systems. In all honesty, this fear isn’t unfounded because the transition phase might introduce vulnerabilities such as “downtime.”

For example, doctors operate on a rigorous schedule while catering to sensitive patient health and privacy issues. As such, they require 100% availability of data (mission-critical information housed in the legacy systems). The minute any glitch or unacceptable loss of service occurs, their service delivery and, subsequently, their patients’ lives could be jeopardized.

Cultural Hierarchy and the Phenomenon of Hero Worship

The complex hierarchical structure is another factor that keeps healthcare providers rooted in their legacy systems. That’s because the structure of a healthcare system customarily dictates how new technology will be implemented.

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And when organizational hierarchy is complex, a strong advocate of the status quo can often dissuade change. A study dating back to 2018 sheds light on the “provider-patient” power relationship. It concedes that almost 70% of the patients never voice out “common ICU concerns.”

This rings true for the current healthcare service delivery too where such imbalance ruins the patient’s experience and complicates the process of synchronization — rendering mere changes in procedure to be likened to a “crisis.”

Then there’s hero worship. Usually, professionals within healthcare institutions develop expertise and affinity towards a workflow, job, or responsibility. So, whenever it comes to an issue at hand, there’s a tendency to default to their personal experience.

Consider this; you’d often hear people saying, “Only XYZ person can do this job.” Or, “Only in our routine way of doing things can we achieve success.”

From the outside, these statements seem perfectly sensible and logical. But, if you look closer at them, they’re actually fundamentally flawed. That’s because they discourage the decentralization of knowledge and authority.

The Accountability Problem

Legacy systems are highly inefficient in reporting due to the stringent functionality, fragmented departments, and siloed data stores. As a result, healthcare providers frequently resort to manual reassurance.

In the IT age, this inability to provide a clear audit trail is a significant hurdle toward trust in the system. Answering “Why did the things break?” and questioning “We don’t know; the previous team did it like this.” is a clear sign of operating in gray areas.

Notably, such blind spots can lead to mismanagement and malicious activity, not to mention the vicious cycle of unaccountability and rigidity.

The Final Word

If you’re a healthcare provider looking to rationalize legacy systems — maybe even overhaul them for better functionality and efficiency — it’s essential to consider the above factors.

In fact, in the post-pandemic era, where the stakes are higher than ever, there’s an even greater urgency to accomplish a smooth transition toward streamlined IT systems.

With that in mind, remain steadfast in your efforts to modernize the legacy systems.

At ADTECH, we’ve been helping healthcare providers harness the power of digital transformation for over a decade, and we’re happy to assist you through this process.

Reach out to us today for a no-obligation, free consultation.

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