[jhayward]

> To give you an idea of the scale, I have two examples. The first is MD Anderson Cancer Center in Houston. They used to have 200+ engineers working on their sophisticated home-grown EMR. It was a huge undertaking. But even with MDACC revenue, that development was unsustainable, and they moved to a 3rd party EMR vendor.

I'm not certain what aspect you are trying to highlight with this example, but readers should know that the MD Anderson implementation of the EPIC EMR system led to a 77% drop in income and layoffs approaching 1,000 people (2016-2017 time frame)[1][2]. I'm not up to date enough to know whether they have ever recovered.

[1] https://www.modernhealthcare.com/article/20170106/NEWS/17010...

[2] https://www.beckershospitalreview.com/finance/md-anderson-po...

[altgoogler]

The point is that even MDACC figured out is was too expensive to continue their own EMR.

You're correct in that literal books could be written about EMR adoption gone wrong. That doesn't change the fact that even super huge mega-health systems can't afford to do it all themselves.

[jhayward]

> The point is that even MDACC figured out is was too expensive to continue their own EMR.

I think then that the example does not prove your point. It would have been vastly better, financially and medically, for MDACC to have continued with their in-house EMR.

[inetknght]

> It would have been vastly better, financially and medically, for MDACC to have continued with their in-house EMR.

...until they (too) fall victim to "a rogue engineer" (or a "patient") coming in and plugging something into an open USB port on the workstation.