Rethinking Tech Debt in Healthcare
When I think of tech debt, I think about when the cost to maintain a legacy application exceeds the value to an organization. There are direct and indirect costs to maintain these tools in healthcare, whether it’s a server, an endpoint device or a cloud-based platform. When that cost exceeds the value, as determined by the organization, then tech debt or disrepair accrues.
Organizational leaders can look at tech debt as a liability on a balance sheet, strictly viewing the issue in financial terms. What they really should consider is tech debt as measured by the potential risks to care delivery and service to patients, keeping in line with healthcare’s overall mission. If tech debt is not addressed in a meaningful way, the cost of keeping the status quo will impact an organization’s ability to be innovative and drive positive change.
Don’t Let Tech Debt Fade into the Background
Healthcare organizations understand that there are risks involved when operating unsupported legacy systems, but fully eliminating such systems would be cost prohibitive, to say the least. No matter how tightly organizations plan for it, there will always be a level of tech debt that’s unavoidable. Every piece of hardware or infrastructure has a shelf life, or a mean time to failure, starting from the date of installation or the date it’s shipped out to a facility.
There are also budget realities that occur every year when replacements are delayed or deferred because there are competing priorities.
And, finally, tech debt requires not just the allocation of financial resources but also human resources. If these resources aren’t well allocated to address tech debt, issues will linger.
For example, Kurt DelBene, assistant secretary for information and technology and CIO of the U.S. Department of Veteran Affairs, discussed making key investments in the agency’s staff to address tech debt. “None of it works unless you have a great investment in people, and people are our greatest asset, and they are a scarce asset,” he said in a 2023 interview.
Still, organizations can mitigate some tech debt by avoiding the implementation of monolithic platforms or solutions, especially if those create more silos instead of fostering better connectivity across an organization’s ecosystem. The healthcare industry is evolving to require improved interoperability, so avoid solution lock-in scenarios that will exacerbate tech debt.
This article is part of HealthTech’s MonITor blog series.