What are Legacy Systems in Healthcare? How to Manage Them?

Updated September 2026

Healthcare organizations are constantly navigating change. From patient expectations and regulatory requirements to new technologies and evolving care models, healthcare leaders are being asked to do more than ever before.

What was once a field dominated by paper forms, manual data entry, and slow information exchanges, healthcare technology has transformed into telehealth, wearable health trackers, cloud-based data storage, and cybersecurity programs.

Modernization can be challenging, especially when aging technology is still deeply embedded in daily operations. According to SOTI’s 2025 healthcare research, 96% of healthcare IT leaders reported challenges involving legacy systems, connected devices, and telehealth technologies.

One factor that often shapes the success of modernization efforts is the condition of an organization’s legacy systems. While many continue to support critical healthcare operations, aging technologies can make it more difficult to adopt new capabilities, improve interoperability, and keep pace with changing business needs.

What is a legacy system, and how can it impact healthcare facility’s transformation to digital? We’ll answer those questions in this blog while also examining the current prevalence of legacy systems as healthcare organizations prepare for the future.

What is a Healthcare Legacy System?

Healthcare legacy systems is a software, technology, or process that is no longer produced, updated, or protected because of new superior technology or lack of maintenance. They are typically foundational pieces of software that support key functions in a healthcare facility. Because technology is constantly evolving, healthcare systems tend to age into legacy systems naturally over time.

The most common reasons for technology to evolve into ‘legacy status’ are:

The technology vendor has discontinued the product, creating an end-of-life legacy system.
The technology is no longer being updated or routinely maintained by the vendor.
The vendor is not actively monitoring for bugs or providing patch updates for cybersecurity.
There’s no way to scale the technology use any further.
The healthcare organization no longer has qualified staff who can operate the technology.

A facility’s legacy footprint may be larger than leaders realize. SOTI’s 2025 healthcare research found that 65% of organizations use unintegrated, outdated systems to support connected medical devices and telehealth. These disconnected environments can make it harder to access real-time patient information, maintain security, and introduce newer technologies across the organization.

How Common Are Healthcare Legacy Systems?

Legacy technology remains widespread across healthcare. In SOTI’s 2025 survey of 1,750 healthcare IT decision-makers, 97% said their organizations still use some form of legacy technology.

Oftentimes, organizations aren’t relying on a single legacy system—they are using a slew of individual applications. Zylo’s 2025 SaaS Management Index found that large enterprises with more than 10,000 employees use an average of 660 software-as-a-service applications.

Why Are Legacy Systems An Issue for Healthcare Organizations?

Legacy systems often stay in place for good reasons. They support critical workflows, store years of valuable information, and may be deeply embedded in day-to-day operations. Over time, however, these systems can become more costly and complex to maintain, requiring additional resources just to keep them running effectively.

Organizations may find themselves relying on specialized talent to support aging platforms while simultaneously managing newer technologies introduced over time. The result can be a complicated technology environment that is difficult to maintain and scale. Not only that, legacy systems open organizations up to serious security risks.

Ransomware continues to expose weaknesses in healthcare technology environments. In Sophos’ 2025 The State of Ransomware in Healthcare report, exploited vulnerabilities were the most common technical cause, contributing to 33% of ransomware attacks. A lack of cybersecurity personnel or capacity was the most frequently cited organizational factor, reported by 42% of respondents.

Because legacy systems may lack ongoing vendor support or require specialized knowledge to maintain, they can create serious security risks. SOTI notes that 45% of IT decision-makers said legacy systems leave their networks vulnerable to attack.

Trends Challenging Legacy Healthcare Systems

Some organizations fear migrating over from tried-and-true legacy systems, but more trends are showing that migration may be necessary:

Cyber attacks against patient data and sensitive healthcare systems are on the rise. Legacy systems may not be updated on HIPAA compliance or may be more vulnerable to phishing attacks, leaving companies open to HIPAA violations.
Internal misuse or insider threat is responsible for a majority of healthcare system breaches. Operating on legacy systems with limited vendor support or employee subject matter experts could increase the number of negligent uses or accidental security breaches.
Organizations rely on patches to their software when vulnerabilities are spotted. Legacy systems often lack the vendor support or patches necessary to ensure the technology is secure as it ages.

What to Consider in Legacy Systems Moving Forward

Although legacy systems can pose risks to organizations, they are also indispensable to others. In situations where legacy systems are necessary for daily operations, it’s key that organizations conduct regular security and performance audits.

Here are some considerations to managing your legacy system moving forward:

Cybersecurity: Keep security at the forefront of operations. Not all legacy systems have vendor support or maintenance. In these cases, extra protocol needs to be taken to ensure regulatory compliance. These protocols can include cybersecurity training, risk assessments, and implementing practices such as the Principle of Least Privilege (PoLP).
Internal support structure: If the vendor is no longer selling or supporting the system, the healthcare organization needs to create an internal support structure to onboard, train, and oversee staff that are knowledgeable about the legacy system.
Compatibility: Consider how well the system connects with newer technologies and workflows. As organizations invest in cloud platforms, automation, and AI initiatives, interoperability becomes increasingly important.
Eliminate data silos: Similarly, legacy systems can become isolated from other systems they weren’t initially built to integrate with. Be mindful of data exchanges with the legacy system and ensure no information lives solely on the legacy system. This creates a data silo.
Performance: As legacy systems continue to age, monitor their performance and its effect on team efficiency to ensure it’s not hindering team productivity.
Maintenance Costs: Factor in the reality of maintaining a legacy system. Does it make financial sense to continue investing money in IT resources or physical hardware to support your legacy system?
Explain the “why” across the organization: Successful modernization is just as much about people as it is about technology. Helping teams understand the purpose behind new systems can improve adoption, reduce resistance, and create stronger long-term outcomes.

Legacy System Transformation Takes Time

Replacing these legacy systems takes time, effort, and lots of intention. However, migrating to modern digital systems is worth it, especially when legacy systems open organizations up to unnecessary risk or unsustainable upkeep.

Modernizing healthcare technology requires the right strategy, the right expertise, and the right people to make change successful. Whether your organization needs specialized talent, consulting support, or guidance on technology modernization initiatives, Insight Global can help you move forward with confidence.