[alextgordon]

It's just reality. Software is easier to change than people. People forget things, get into bad habits, have non-perfect understandings, ulterior motives, and all sorts of other flaws.

If your software relies on fixing flaws in humans, it's probably going to fail.

[sneak]

Actually, it directly depends on how many people. Good software is expensive, and if your staff is below a certain number, it may be cheaper to just use the stick. I think this is why hospital software systems are so abysmally bad. They have people who are accustomed to complex training, and software that costs a small fortune to deploy.

[vacri]

Part of the reason why hospital software is bad is because of the intense politics involved, complete with fiefdoms and sales reps with shiny toys.

A friend of mine used to be in Quality management at the Royal Children's Hospital in Melbourne, here are two (of many) stories

The hospital patient management process is somewhat paralysed because every department has its own custom system for managing patients. He was involved in trying to get a hospital-wide system in, but the CEO was more interested in "making her mark" than managing the hospital, which would require forcing the point with the department heads. So quite frequently patients moving between departments would not have their receiving department ready or even aware of their arrival. Generally the issue was that either department heads liked the shiny toys brought by sales rep -foo- (doctors get a lot through sales rep gifts) and didn't want to change because they'd stop getting them; or that the doctor was stonewalling because they didn't want to learn a new system. Classic case of everyone saying "something must be done... by someone else!". The kicker is that no matter how persuasive your argument might be, the doc would have the last word with "children will die if I can't use this software" and the argument would end.

The other story is much shorter: at one bigwig's meeting, one of the senior specialists - a 27-year veteran - shot down a new doctor's comments saying that he wasn't familiar with how things work here. The new doctor's reply? "I've been here 17 years..."

I've had a microcosm of this experience as well. While installing monitoring gear for one of the departments, the department chief went ballistic because the new computers had power cables that were touching the desk: "It's written into the quote that the power cables will not touch the desk!". Nonsense, of course, but it's how she gets things to her liking - she was the poster girl for post-contract feature changes. I would have called her on it to try and forestall the next few things that were 'in the contract', but my company was spineless and would never have backed me up.

I guess the short form is: a large part of the reason why software is terrible in hospitals is because not many people that have a say are actually evaluating the software properly.

[DanBC]

> I guess the short form is: a large part of the reason why software is terrible in hospitals is because not many people that have a say are actually evaluating the software properly

There's a special case for England's "connecting for health" $18billion nightmare.