Having attempted to do exactly that, I have gotten a little wiser about just why the existing software is so bad, and why it's hard to supplant. Writing better software isn't the hard part.
As you alluded to, it all comes down to the difficulty of selling to them. No matter the size of the customer, they all seem to take two years to make up their minds to buy. That is pretty harsh on a scrappy startup. To grow quickly, you need to pour a very significant pile of money into an enterprise salesforce two years before you actually want to start making money.
That also leads inexorably to the conclusion that small customers aren't worth the hassle, so you need to target the behemoths who can spend enough money to justify their acquisition cost. And the behemoths are so scarred by years of disastrous IT projects that they are deeply risk-averse.
I also think the industry remains in denial about the strategic value of software, so you don't actually get paid what you're worth. They all know they need software, but they see it more as a necessary chore than an opportunity to revolutionize their business.
My hope is that a real technology company directly enters the healthcare market and starts kicking butt by building their healthcare services around great software from the ground up. That would shake the incumbents out of their denial.
Hospitals/Big Healthcare need to be sure the vendor will be around for a decade or three. It is very hard for a startup to offer this assurance in a believable manner. It will take someone like Google to tackle this.
Right, part of their problem is that they're demanding the wrong thing. Instead of demanding a high degree of stability from one vendor, they should be demanding open standards and real interoperability, so their eggs aren't all in one obsolete basket.
Wrong. This is like saying we should demand only a small degree of reliability from airplane wings, but we should make them easily replaceable.
I don't think their insurers would like that. When medical records start getting lost/exposed because of small outages or vendor changes, the Feds will come down very hard.
As you alluded to, it all comes down to the difficulty of selling to them. No matter the size of the customer, they all seem to take two years to make up their minds to buy. That is pretty harsh on a scrappy startup. To grow quickly, you need to pour a very significant pile of money into an enterprise salesforce two years before you actually want to start making money.
That also leads inexorably to the conclusion that small customers aren't worth the hassle, so you need to target the behemoths who can spend enough money to justify their acquisition cost. And the behemoths are so scarred by years of disastrous IT projects that they are deeply risk-averse.
I also think the industry remains in denial about the strategic value of software, so you don't actually get paid what you're worth. They all know they need software, but they see it more as a necessary chore than an opportunity to revolutionize their business.
My hope is that a real technology company directly enters the healthcare market and starts kicking butt by building their healthcare services around great software from the ground up. That would shake the incumbents out of their denial.