In healthcare, legacy applications serve critical roles in driving health system operations, but as the health tech field continues to evolve with the introduction of new workflows, software and hardware, CIOs must determine when to replace this technology with newer technology.
Daniel Uzupis, CIO of Fairfield, Iowa-based Jefferson County Health Center, said he determines when to upgrade a legacy system based upon three principles — security, reliability and resilience.
"The determination to upgrade a legacy system is based upon providing the most secure, reliable and resilient environment to our patients," said Mr. Uzupis.
At Seattle Children's, Zafar Chaudry, MD, senior vice president and CIO, determines when to upgrade by reviewing his organization's systems to see if they are continuing to meet daily business needs and IT metrics.
"We review business and clinical system validity every five years. This is undertaken in collaboration with the application owner or lead clinician," said Dr. Chaudry. "We also review system security, software version and functionality (however, system security patching is always kept up to date). The decision to upgrade a system is driven by the application owner or lead clinician subject to available funding."
Costs are also a bigger driver in replacing legacy systems, as these older systems tend to require extra resources with specialized skill sets to manage, which don't always support the agility, flexibility and streamlined business operations that health systems demand.
"Legacy systems are often more expensive than newer systems, though the costs are sometimes less apparent," said Susan Snedaker, CIO of Tucson, Ariz.-based El Rio Community Health. "Hardware and software maintenance and support costs usually climb significantly with end-of-life legacy systems. And there usually are challenges when it comes to hiring (or retaining) staff with legacy system skills such as old operating systems, programming languages or database systems."
Ms. Snedaker also said costs add up with these systems, as there are often issues with system performance that can impact staff and productivity.
"These types of costs often add up to very expensive legacy systems, though few organizations tend to spend time documenting these costs. In order to evaluate when it's time to upgrade, these factors must be considered along with the evolving business needs," said Ms. Snedaker. "Understanding the desired future state is the basis for developing a meaningful technology roadmap, which will then guide the organization in the replacement of legacy systems."
Other times, metrics may not be the reason an organization decides to upgrade its legacy systems.
According to Saad Chaudhry, CIO of Annapolis, Md.-based Luminis Health, there isn't really a general metric that applies across the board.
"Sometimes it's the market itself. In the cases where 'I want to have the latest and greatest,' I tend to compare what my vendor's competitors are doing for their 'next generation product' to what my vendor has planned," said Mr. Chaudhry. "If there is a giant disparity between the two, the future upgrade path can become clearer."
Similarly, there are times when your organization is fine being on a legacy system as long as it is dependable and still gets the job done.
"In this case, most of the time you would upgrade only if the operational and budgetary resources needed to keep it running began to creep up towards the cost of a complete upgrade," said Mr. Chaudhry.
Lastly, one of the largest "must get off this legacy platform" flags is if cybersecurity becomes an issue.
"If a system runs on an operating system or hardware that is so far beyond end-of-service that it does not even get critical security patches anymore, it's time to upgrade," Mr. Chaudhry said.