Longevity
Many people I work with do not like changing their routine, this is nothing new, but what makes the healthcare industry different is that there seems to be no pressure on the business itself to force very many changes, unlike more technology based companies which are forced to change their procedures in order to become more competitive within their own market. This is why longevity of the database is a much more important factor than in any other tech. industry. Remember that when you are introducing a database to a healthcare environment, the solution itself could easily still be in use after 10 or 20 years. For Flat File databases, this may actually be good news. Flat File databases are usually proprietary, that is they are only used by a single application. this means that the lifetime of the database usually equals the lifetime of the application.
One thing to check for is Operating System compatability. Will the application work on the latest version of the Operating System? I have personally run into situations where an application’s database was 2 versions older the current version of our primary SQL Server. This version was still being supported at the time we were considering it but within just a few years this could have become a real problem. If your new 64bit Server Operating System no longer supports your 16 bit database, you could end up attempting to keep an old NT server around hoping it won’t become infected with a computer virus that won’t be detected because the OS is no longer patched and no current Antivirus programs will run on it.
I’ve seen ISAM databases that came and went, and I wouldn’t want to be someone stuck with an application that uses a database that has not seen a new version in many years. This leads to higher maintenance costs and more resourse demands.
The more robust Client/Server databases usually have well defined upgrade paths so that products that are supported under an older database can be upgraded every so often to support a newer database and hardware.
