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

In recent years, new technology has helped industries embrace full-scale digital transformations. That trend is advancing rapidly in the healthcare industry.

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.

Not all transformations are smooth, however, with only 30% of organizations reporting successful digital transformation projects post-COVID-19. One of the biggest determinants of successful transformation is the status of an institution’s legacy systems.

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 and trends challenging them in 2023.

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The technology is no longer being updated or routinely maintained by the vendor.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 footprints are likely larger than realize, and the number of legacy systems continue to grow year over year. The U.S. IT market was valued at $96 billion in 2020 and was anticipated to reach $344 billion by 2030. This level of spending will continue to put a strain on existing legacy systems and impact the organization’s ability to facilitate successful digital transformations.

How Common Are Healthcare Legacy Systems?

According to a 2021 HIMSS survey, nearly three-quarters (73%) of healthcare providers rely on legacy information systems. Oftentimes, organizations aren’t relying on a single legacy system—they are using a slew of individual applications. A 2022 Mulesoft report found that the average organization uses 976 unique applications, and that number was increasing annually. A number of those applications are likely legacy systems.

Why Are Legacy Systems An Issue for Healthcare Organizations?

Organizations that hold onto outdated systems create bloat within the business. This bloat results in a high cost of ownership and is a drain on company resources. Companies will often have to hire special staff to operate the old systems, or they’ll have to juggle multiple systems that all do similar things. Not only that, legacy systems open organizations up to serious security risks.

Cybersecurity attacks are on the rise, and two-thirds of healthcare organizations reported a ransomware attack in 2021. Because legacy systems can lack vendor support or employee knowledge to maintain their security over time, it creates a major risk for organizations. That is why legacy technology was reported as the third-biggest security challenge facing healthcare cybersecurity programs in 2022.

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 the system interacts with other technologies over time. Make sure it remains compatible and information is properly funneled across channels.
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: A system upgrade can stop dead in its tracks if middle management and supporting teams don’t know why these new systems are better and how they work. When it’s time to upgrade these systems, make sure the entire organization knows not just what the new system is, but why it’s an upgrade.

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.

Are you considering a digital transformation for your legacy healthcare system? Along with Evergreen, our professional services division, Insight Global can modernize the system and build and manage teams that can help with this transition. Reach out, and let us know your organization’s needs!