Hacker News Reader

I see. PACs which are the storage and index systems for medical "imaging" data have seen some pretty big in roads. HL7 processing has become dominated by open source. There is huge institutional inertia to overcome in any corner. You really need to offer something 10X better to get over the "no one ever gets fired for using EPIC" mentality and that's a very high bar.

View on HN

Thanks for the keyword pointers. This is a bit outside my expertise: family on provider side, but I work more on the insurance side of the house.

In insurance, there seem to be some moves towards cracking monolithic systems into pieces for reasons of development agility. ACA limiting admin costs is a huge driver, as companies rightly identified lack of technical agility as a existential threat (no agility = no ability to update automated processing pipelines to changing requirements = manual processing = penalties for exceeding allowed admin costs).

Also, I think there's a generational shift at the executive level from "Buy and trust vendor" to "Own, develop, and operate."

not just ACA but general market pressure to lower admin/PMPM costs due to increased competition and providers beginning to taking risk on directly in insurance

Reply on news.ycombinator.com