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Some larger hospitals already have this, or had something like this. I know personally of one that had an in-house engineering team and it was slowly dismantled in a process of outsourcing, until the remainder of the team resigned as a group. It caused a certain amount of chaos. EHR is sort of similar. To me, the roll-out of that was a disaster, and pushed what was in-house in most cases to being managed by EPIC and other EHRs out of the hospital. The mandates were a big mistake in my opinion, as it forced hospitals to scramble to use something being offered by outsiders, instead of collaborating to produce something open-source, or growing EHRs more organically from within the organization. I personally blame the rise of hostageware in hospital settings partially on this trend. My broader point is that although I think there's a lot of potential with open source hardware, software, and things like 3D printers, prevailing economic forces are pushing in the opposite direction. Consolidation and mergers, streamlining everything that doesn't contribute to increasingly dense profits as you go up the administrative chain. In this schema, better to outsource everything you can to trim costs. I don't agree with it, as I think it leads to a lot of hidden costs and hidden but lost benefits, but that's the idea. Unfortunately, the combination of overregulation and profit-driven hierarchical management is creating pressures against in-house, from the bottom up creation of goods and medical services. The talent is there, it's just pushed out from the top. Sometimes I feel like healthcare and the biomedical area is today driven more by the interests of profiteers than patients/clients/customers. |