Healthcare.gov confirms hackers stole income, immigration and tax data

There was a study in the 00s that looked at major IT system implementations, and I can’t remember the exact number, but it was around a 77% failure rate for business and around 85% for public sector systems.

Which frankly make a lot of sense. Because the public sector buys its systems from the same software companies that the private sector does.

I don’t necessarily think giving up is the best sollutuon though, I think it would be better if we demanded a higher priority on IT from our political leadership than we do now. I mean, we’re seeing some with the GDPR, but did we really have to rely on the EU to do the right thing?

In the perfect world, you could design an architecture for sharing data, so patients would own some sort of medical card with their history.

In the real world, your doctor and your eye doctor bought different IT systems that can’t share data without someone manually typing them in.

Hell, the hospital probably runs around a thousand different IT systems and maybe two of them have APIs, but one is SOAP and the other is Graphql and there isn’t any middleware to make them speak with eacother. So the hospital can’t share your journal between your ward and the X-Ray room, unless there is a centralised journal.

We’re working toward a better architecture, but it’s not easy, and if only 500 of your 1000 systems adopt it, then you’ll still need a way to handle those 500 systems.

Things are made worse by the political decision organ and it’s variating agendas.

For a decade you may have political leadership that enforces an open architecture in which systems have to be able to share data. And you get maybe 10 major systems build on it, and they work, and you build some middleware and use RPA for some of the other systems.

Then the political landscape shifts, and maybe lobbyists play a part. Because open architecture for data is making companies less money since they can’t sell you data extractions. So they spend money on politics, and the conservative side listens and starts making the open APIs and public ownership and management illegal because it “steals” jobs.

Then you have another decade where you change another 10 major systems, except now they are silos and you fire your local IT developers so you can’t build RPA or middleware.

Then people realise that was stupid, so it shifts back to open architecture. Except now 20 years have passed, so we design a new open architecture that doesn’t fit with the old one. And then we buy another 10 major systems on the new architecture.

Now, after 30 years of good intentions, you still need a centralised way to share patient data, and when it fails, people do die.

> Is there some dire pressing need where people are literally dying because doctors can't access prior medical history in time

People definitely do die from that.

Not to a sufficient level.

(Asking because I'm starting a new data-heavy project and I'm considering generating code from UML.)

Maybe people should stop thinking software is cheap.