In part 1 of this blog, we talked about the financial costs that healthcare organizations have to bear when managing their legacy application estate. But…
Legacy applications cost more than just money!
I’ve often heard the expression, ‘it’s not all about money’ – and, in the case of the cost of legacy applications, that’s certainly true (albeit a monetary value can likely be placed on all of things I am about to cover). So, what are the softer or hidden costs that we should consider in relation to running legacy systems?
Lost clinical productivity and burnout
One of the less quantifiable but equally critical costs is the impact on productivity. Clinicians and support staff barely have time to look in their primary systems to get to the patient information they need when delivering care. Yet there is an unrealistic expectation they must log in to multiple other disparate, siloed systems in order to get a comprehensive patient history when consulting, diagnosing, and/or treating patients. Often time is wasted navigating clunky interfaces and waiting for screens to load. Over time, these bottlenecks lead to a noticeable loss in productivity, and negatively affects staff morale and potentially patient care. It’s well reported that this extra administrative effort is a significant contributory factor to staff ‘burnout’.
As legacy systems age, their software and hardware become more vulnerable and, as a consequence, are increasingly susceptible to cyberattack, be it ransomware or malware. Healthcare is a prime target for unscrupulous ‘bad actors’ and, in recent years, we’ve seen the devastation caused by such security breaches, and the reported resulting cost and reputational damage. It’s certainly not a pretty picture. And one of the main differences between healthcare organizations and other industries is the potential impact on patients’ lives. (Note: this is a subject we will be covering in more detail in an upcoming blog where we will talk more about the security implications of legacy systems).
The IT burden of managing legacy systems
Many of our customers tell us their IT department is ‘stretched’ – constantly having to ‘do more with less’. The prevalence of legacy applications within a hospital is certainly not helping. According to a 2021 HIMSS survey, 73% of healthcare providers have legacy information systems. Managing these applications takes up a disproportionate amount of IT time and resource to not only maintain, but also protect (i.e. backup and recover). This carries a heavy opportunity cost – namely, what other strategic initiatives and projects could the IT department be working on if that time and resource were re-allocated. And just to make matters worse, health IT teams have to ensure staff have the requisite skills and knowledge to manage these legacy applications. If they don’t, it generally means outsourcing. However, as the scarcity of these skills diminishes in the market, the cost of external support for these systems generally increases.
Keeping legacy applications compliant with evolving healthcare regulations can be difficult, time-consuming, and costly. The healthcare industry operates under strict regulations; and there are a plethora of laws, policies, and codes of practice, in place across the globe. This range from data protection and privacy mandates, as established under HIPAA in the United States, or GDPR in Europe; through to data retention policies (i.e. how long should data be kept – which varies from country to country, department to department and is a topic in its own right). Meeting these obligations is challenging at the best of times, but legacy applications often struggle to keep up with these ever-evolving regulations. And non-compliance can lead to substantial fines and legal ramifications.
Lack of interoperability
Interoperability has and continues to be a huge focus for the healthcare industry. The ability to interconnect data from one system to another, and even across care settings and networks, is critical for the efficient and effective delivery of healthcare. New data standards, such as FHIR, are essential to creating meaningful clinical workflows – putting the right information in the hands of those that need it, where they need it, when they need it. But, unless we retrofit applications with these interoperability standards, managing the flow of data from legacy systems will be almost impossible or, at the very least, complex and costly.
The cost of inertia
When it comes to legacy systems ‘business as usual’ or the decision to ‘do nothing’ is no longer a viable option for healthcare organizations. Historically, there were no easy solutions to address the problem, but that’s no longer the case. So, those putting their proverbial ‘head in the sand’ ‘won’t cut the mustard’ (how many idioms can I cram into a single paragraph?). There are simply too many moving parts to maintain the status quo; and there is too much at stake.
The monetary cost is, of course, an important consideration; and healthcare organizations who are tackling their legacy application estate are reaping the financial rewards. But there are many other growing implications for those trapped in a state of inertia – from productivity challenges to security risks, compliance issues to data interoperability.
Some practical next steps
It won’t be a surprise to you that my view is that the costs associated with legacy applications, in all their guises, can’t be ignored. But you should never take any one person’s word for it. Instead, you could do a simple, raw analysis – even a rough assessment can be insightful.
- How many legacy systems do you have?
- What are your estimated license, support and maintenance costs?
- How much time and resource are you committing to the upkeep of those systems?
- Anecdotally, ask staff about the impact of these applications (such as ease of use, speed of access, or challenges they may present?)
- What does the cybersecurity risk profile of these systems look like?
After identifying your legacy applications, prioritize them in terms of those most important to tackle first. This will all help paint a picture of your current situation and assist when considering next steps. Alternatively, you might prefer a more formal exploration of your legacy systems, in which case we’d be delighted to have an introductory conversation.
Retire your legacy systems whilst preserving access to their data
For full transparency, BridgeHead Software offers solutions that enable healthcare organizations to retire their legacy applications whilst preserving and providing access to the data they contain. BridgeHead’s HealthStore® is an enterprise-wide, cross-department, Clinical Data Repository that consolidates, stores, protects, and provides access to all manner of information, whether from legacy or live systems, all in one place!
By extracting then ingesting your legacy data within HealthStore, you can effectively decommission and retire your source, legacy applications – saving you time, money, and resources; all whilst reducing your security vulnerabilities and associated risks. But, importantly, your clinicians and support staff across your ecosystem can access your legacy information as part of the patient record (via integration with the EHR or other primary systems) anytime, anywhere, and on any approved device, whilst in the course of delivering care to patients.
Working in tech marketing for almost 30 years, and specifically in health tech for the last 13 years, John has and continues to learn about the real issues faced by healthcare providers and is convinced that technology, when specified and implemented correctly, can be a ‘game changer’ in the delivery of patient care.
At BridgeHead Software, John is working to disrupt the myopia around healthcare applications instead supporting the view that data (and not applications) is the strategic asset by which patient outcomes and experience can be improved.