[batata_frita]

Did OP forget the world is economic driven?

The hospital software is not updated in a frequent base because it doesn't generate more money. That's why the hospitals, bakeries, hotels and many other business doesn't have UI/UX top tier profissionais as YouTube, iOS, NetFlix, Facebook, TikTok and many many other websites, systems, companies, etc have.

Simply put, because it would not make money! We leave in an world of attention economy where as much time people spend on screen as much companies make money.

It's no secret at all.

[kmoser]

Another barrier to replacement is that the existing software embodies a ton of domain-specific knowledge and handles many arcane exceptions. To replace it you would have to be an expert in that domain, which is a huge blocker for all but a few players.

[faresahmed]

I disagree, many businesses that put their software in maintenance mode (fix/upgrade on breakage) will be losing money in the long run.

Consider a hospital, many statistics can be collected o provide insights and make immediate decisions, faster algorithms and new ones to problems we couldn't solve back then have been discovered, the UI/UX can always be improved for productivity, etc. All of that makes money.

Software customers aren't, and shouldn't be, one-time shoppers; there's always room for improvement and new needs pop up all the time.

[nradov]

None of that really makes money for a hospital. Most of what hospitals do is direct, hands-on patient care. Software improvements can at best deliver some small cost savings or slight reductions in clinical errors. And many hospitals are non-profit or government run, so there's not even a direct management incentive to improve financial performance.

Do you know what makes money for a hospital? Buying a new MRI machine. They can directly charge customers for scans. In budget planning cycles any proposed IT upgrades have to compete against stuff like that.