It isn’t just security.
The problem is, that with changing regulations and capabilities in medicine, systems have to be able to adapt, and I have seen a lot of systems that have figurative “hardening of the arteries”, that is, they become so crusty with layers of adaptations over time, that they simply reach a kind of block obsolescence and upgrading becomes more and more difficult over time.
I have had to say goodbye to systems that were perfectly fine in my eyes, but were completely unsatisfactory in the overall scheme of things.
And you never want to reach the state where you have to upgrade at the point of a gun (figuratively speaking)
I agree. The addition of bureaucratic rules has burdened the VA medical record system immensely.
They started using the medical records system to create treatment statistics and then began altering the records to improve the statistics.
The VA has also started data mining their medical records system to predict individuals most likely to commit suicide for closer monitoring.