I used to work IT for a College of Pharmacy and had to occasionally deal with the IT for the enormous health system: http://med.umich.edu http://med.umich.edu.

I used to work IT for a College of Pharmacy and had to occasionally deal with the IT for the enormous health system: http://med.umich.edu http://med.umich.edu. There are pockets of competence and the occasional really cool project, but "screwed up" is a good descriptor. The people who have decision making authority or political weight, doctors and administrators are completely clueless. While typically highly intelligent, their training tends to turn them into savants. These people making decisions, and the users in nursing all ask their kids for help at home with this type of stuff. IT staff have to support a userbase that is much older than most other industries (http://www.vcstar.com/news/2010/jul/10/records-show-about-half-of-ventura-countys-and/?print=1 http://www.vcstar.com/news/2010/jul/10/records-show-about-ha...). IT cannot assume competence. There is absolutely no incentive to get this stuff right. Most healthcare systems are rolling in money, so IT staff levels are typically huge. The correct way to protect these fiefdoms is to not screw up and not get noticed. Admin will keep throwing money at you so long as they don't have to think about you. In the health system, IT has no political weight. It's regarded slightly better than janitorial staff. Which affects (non-monetary) resource allocation and recruitment of IT talent. A brief anecdote. The College of Pharmacy had a contest requiring some of the hospital's pharmacists to score videos of student-patient interviews. They had to do it at home. There are departments at the hospital that do incredible work and research with imaging tech, but their pharmacists can't view a 5 minute video clip in any format.