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Carina C. Zona

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"There are various ways to ensure customers stick around as long as possible — lock-in or loyalty. Successful SaaS businesses are built on the loyalty model. Rather than holding data hostage or locking customers into long agreements, they believe that the more freedom you give customers, the more loyal they become (assuming you deliver the goods). In contrast, there’s still the antiquated model of lock-in used in many healthIT vendors. For example, they make it expensive and/or difficult to get access to data in a system to keep any in-house or 3rd party built system from being integrated. These vendors pull it over on naive customers by telling them that it’s a ton of work when it’s only a ton of work if that vendor is incompetent….

The cost and complexity of testing new models prevented many from being tried. Even today, the leading HealthIT vendor is known to charge $100 million and up for its software and it takes a long time to implement."

Dave Chase, explaining in Forbes why "Health IT is Terrible"

It's hard to watch any client spend huge sums on a clumsy implementation of an outmoded solution, let alone when excellent modern solutions are widely available and at trivial price overall. As a consultant, it can be valuable to keep in mind that the job is to advise clients of options and to accept that they'll decide as they may. Organizations make decisions for many reasons, and what looks irrational from the outside is often being rationally driven by internal necessity to deal with a complex array of barriers to the optimal solutions.