Healthcare software modernization overview: your guide
In today’s business landscape, many leaders must navigate the complexities of ever-evolving market dynamics. Without being an exception, healthcare organizations are facing the challenge of modernizing legacy systems.
But what exactly are legacy systems in the healthcare context, what are their characteristics and shortcomings? And what is the best strategy to approach legacy modernization?
What is healthcare software modernization?
Legacy systems are already outdated applications and infrastructures that are still used despite obsolescence. These are typically complicated to maintain, don’t receive regular updates and patches, and pose various risks that restrain business growth.
Legacy systems’ key characteristics usually include:
- Outdated technology (programming languages, operating systems, and databases)
- High costs
- Security vulnerabilities
- Compatibility issues, and other technical shortcomings to which we will get below
When is healthcare software modernization necessary?
With common funding shortages and other pressing issues, it’s tempting to postpone legacy modernization. And still, the longer you wait, the more legacy challenges you’ll have to resolve.
As to HIMSS 2021 cybersecurity survey conducted among domain professionals in the healthcare industry:
- The majority of respondents, which make over 73%, have legacy operating systems in place
- The respondents experience legacy operating system footprints across healthcare organizations ranging from either 1-10% or 11-20%
- For 39% of respondents, legacy technology is presenting a serious security challenge
- For 34% of respondents, managing updates and patches is another daunting challenge
The types of legacy healthcare systems
The types of legacy healthcare systems might encompass different software that lost initial relevance:
- Electronic health records (EHR)
- Electronic medical records (EMR)
- Hospital information systems (HIS)
- Laboratory information systems (LIS)
- Claims processing software
- Patient engagement solutions
- Radiology information systems (RIS)
- Pharmacy management systems (PMS), and others
Electronic health records (EHR)
EHR systems are used to store, process, manage, and share patient records across many healthcare facilities. They enable patient registration, appointment scheduling, medication management, laboratory integration, and interoperability between systems.
When obsolete, EHR software might cause:
- Slow performance
- Data fragmentation
- Security vulnerabilities
- Regulatory non-compliance
Electronic medical records (EMR)
EMR systems are used to organize and share patient records between personnel within one healthcare facility. They enable clinical documentation, prescription tracking, accurate diagnosing, patient-centered treatment, and other in-house processes.
When obsolete, EMR software might cause:
- Inefficient workflows
- Data discrepancy
- Administrative burden
- And poor resource utilization
Hospital information systems (HIS)
HIS are centralized platforms for managing hospital-specific operations – administrative, financial, and others. Patient admissions, bed management, inventory control, staff scheduling – all these are handled by leveraging HIS software.
When outdated, such systems might cause:
- Increased downtime and disruptions
- Reduced efficiency and productivity across departments, and other internal challenges
Laboratory information systems (LIS)
LIS are specialized solutions for managing laboratory-only workflows – test orders, result reporting, and more. Test processing, sample tracking, and even regulatory compliance are handled by implementing LIS software.
If outdated, such systems might deteriorate:
- Lab processing
- Data integration
- Test volumes
- And overall lab outcomes
The need for legacy healthcare modernization: key indicators of risk
| Performance issues | Noticeable slowdowns, system crashes, and inability to handle increased workload, which lead to delays in routine administrative processes and everyday patient care. |
| High costs | Rising expenses for continuous system support, regular updates and patches, bug fixes, which make legacy software intolerably unsustainable. |
| Security vulnerabilities | Data breaches, malware, phishing, insider threats, identity theft, zero-day exploits, and non-compliance. |
| Scalability limitations | Growing struggles with growing patient volumes, new services, cloud adoption, and other scalability-related metrics, which restrict business expansion. |
| Interoperability issues | Difficulty integrating with modern telehealth and telemedicine platforms, medical devices, and more. |
| Discontinued support | Discontinued support from original technology providers, which leave healthcare organizations extremely vulnerable to potential security threats. |
| UX/UI problems | Outdated interfaces, complex navigation, and other common problems, which cause user frustration. |
| Regulatory challenges | Difficulty meeting HIPAA, GDPR, and other industry standards, which exposes healthcare organizations to serious legal and financial penalties. |
Healthcare software modernization projects: our process
Step 01. Assessment & strategy planning
At this project stage, we evaluate the existing healthcare system to define the best modernization approach. This ensures our efforts are aligned with specified business goals, industry standards, regulatory requirements, and trends.
This includes:
- A comprehensive legacy audit to assess overall performance, technical debt, and other critical factors
- A thought-out strategy planning to address pressing needs
Step 02. Technology & infrastructure planning
At the next stage, we design a modern, future-proof architecture and choose the most appropriate technology. All this, of course, by communicating and collaborating with stakeholders.
This includes:
- The identification of modern technology stacks (cloud platforms, microservices, containerization)
- The planning of upgrades
Step 03. Data migration
Moving further, we ensure a secure, seamless transfer of important healthcare information to the new system. Without planning, we’d experience data duplication, integration failures, data loss or corruption, data leakage, and other unwanted problems.
We cover:
- Data cleansing to remove existing redundancies and inconsistencies
- Data protection to prevent data loss or corruption
Step 04. System migration and modernization
Then, finally, we implement the chosen, best-fit strategy to facilitate current functionality and maintainability. When rushed, this could easily cause technical debt, poor code, security vulnerabilities, compatibility issues, and more common problems that endanger the system.
We cover:
- Either encapsulating, rehosting, refactoring, or rebuilding the existing legacy application
- API development to facilitate data exchange with other healthcare-specific applications
Step 05. Integration & interoperability provisioning
At this project stage, we ensure the system can connect with other healthcare technology without trouble:
- By ensuring regulatory compliance (HIPAA, GDPR, HL7, FHIR, and other industry standards)
- And addressing potential challenges with integrating third-party services
Step 06. Testing & quality assurance
At this project stage, we ensure the system’s overall stability:
- By performing functional and performance testing
- And conducting load testing to ensure the system can handle high traffic
Step 07. System deployment
We deploy the modernized c application while ensuring minimal disruption:
- By using a phased rollout approach
- And offering various parallel run options before transitioning
Step 08. System support and maintenance
We support and maintain the application to avoid performance degradation and other common shortfalls:
- By implementing real-time monitoring and alerts
- And optimizing system capabilities
Healthcare software modernization planning: what approach will suit your case?
| Brief description | Best application | |
| Encapsulation | Encapsulation extends the lifespan of applications by wrapping existing functionality without altering the code. | Legacy systems that still provide value but need better integration with more modern solutions. |
| Rehosting | Rehosting (or “lift and shift”)” migrates the application to a new infrastructure without changing the code. | Legacy systems that still perform well but need greater scalability and other cloud-native features. |
| Refactoring | Refactoring involves the modification and optimization of code without changing its behavior. | Legacy systems that have technical debt, need modernization without rewriting, and provide business value. |
| Rebuilding | Rebuilding involves the rewrite from scratch by using modern technologies while maintaining core functionality. | Legacy systems that have severe limitations, poor architecture, and are unreasonably expensive. |
| Replacing | Replacing means basically retiring the existing legacy system and implementing a new, ready-made solution that meets business needs. | Outdated systems that no longer align with current business goals and can be replaced with an off-the-shelf solution. |
| Rearchitecting | Rearchitecting involves the modification of the fundamental structure to improve the performance and scalability. | Older systems that need greater scalability or migration to a cloud-native architecture. |
Healthcare systems modernization benefits
Why would you go for legacy healthcare modernization?
No more operational bottlenecks
Legacy systems usually struggle to process high volumes of information, thus causing insufficient performance. By leveraging healthcare modernization, you enjoy faster responses, continuous processes, smooth workflows, and, accordingly, patient satisfaction.
Sensible savings
Legacy systems are unrewarding to maintain, as discontinued vendor support is causing numerous challenges. But leveraging healthcare modernization, you lower long-term expenses by eliminating bug-fixing emergencies.
Strong security
Without receiving regular updates and patches, legacy applications are becoming more prone to cyberattacks. Modern systems don’t have such shortcomings.
Supported scalability for future business growth
Older applications cannot handle the changing market demands – AI integration, RPA technology, and others. Modern architecture is introduced to allow seamless scalability without experiencing infrastructure constraints.
Healthcare platform modernization challenges
Are there any challenges worth considering before legacy healthcare modernization?
Data complexity
- Legacy systems usually store vast amounts of information in unstructured, outdated formats
- Some systems are using custom-built logic for specialized medical calculations, which may not have direct equivalents, thus requiring careful reconstruction and validation
Lost documentation
- Many systems were built decades ago, often with insufficient documentation
- Hidden dependencies between modules or other third-party components can break the functionality during modernization
Monolithic architecture
- Many systems are monolithic, which makes it difficult to introduce new features without disrupting other elements – breaking down into microservices requires careful service decomposition
- Poor implementation of microservices can cause deteriorated performance, unnecessary complexity, and other unwanted issues
Third-party integrations & components
- Legacy systems usually rely on external, third-party integrations – medical devices, reporting platforms, and proprietary diagnostic tools, which requires accurate rewriting
- With discontinued vendor support, some components might require additional workarounds
How we can help
Over time, legacy software will cause daunting challenges, from performance and functionality to compliance. This is especially true once the legacy software is no longer aligned with current business needs and objectives.
So, why delay modernization?
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Our expertise:
FAQ
A legacy healthcare system is an outdated software or infrastructure that no longer meets modern standards. These include industry requirements for support and maintenance, regular updates and patches, and more.
Old legacy healthcare systems become inefficient when they:
- Have low performance levels
- Pose serious security vulnerabilities
- Lack interoperability
- Are expensive to support and maintain
You might need healthcare application modernization if the current system isn’t meeting your requirements. These include adequate performance, flexibility, scalability, and other critical indicators, especially security.
You might require healthcare data modernization to move from fragmented, siloed databases and leverage:
- Real-time access to relevant patient information
- High-level security
- Advanced analytics
- Regulatory compliance, and other modern features
- Improved automation and performance
- Enhanced interoperability with modern healthcare technologies
- Greater scalability for future healthcare innovation
- High-level security
As well as facilitate care delivery and outcomes.
- Initial investment
- Complex migration and potential downtime risks
- Additional training
- Regulation-related complications
And challenges associated with data migration in particular.