See my post at #39. Upgrading a company that has a relatively homogenous software distribution is not all that bad I would think, just the initial costs, setup and training.
But in a large medical environment, there are hundreds or even thousands of different vendors whose software has been used relatively reliably for a long time, and hasn’t been upgraded as often due to the onerous testing regimens that have to take place with every piece of medical software.
We have been unable to upgrade from Windows XP in the area I work in because the vendor of the software (used throughout the institution for critical imaging functions) has not delivered a version that can work on both XP and Windows 7. We need the memory benefits of Windows 7 in my area, but the rest of the hospital cannot justify the costs of upgrading.
And for us, even though we have server-grade hardware being used as workstations for the physicians who must have that kind of performance, we faced budgetary constraints because the high-end specialized video cards have to be replaced in all of them (can’t be used in Windows 7)
There are a lot of factors involved. And don’t get me started on applications wedded to specific versions of Internet Explorer. I bloody hate it.
You’ll be forced to upgrade eventually. Without patching support the XP machines aren’t HIPAA compliant. (IT Security standards)
There is an opportunity for a programmer to make money on things like that I think. I hear that every police station in France has switched to Ubuntu. That is at least several thousand copies of Windows not purchased, I see things like that spreading.