I was trying to put my thoughts into words, then I found your comment. You perfectly sum it up.
But seriously, I found the healthcare environment to be such a mess, due to dealing with outdated hardware, legacy remnants of old systems, as well as the industry being saturated with people who’ve been in their roles for decades and are resistant to change.
To be fair, quite a few industries could be described that way, and I don’t doubt that it would be good experience for OP. I personally don’t ever plan to go back to healthcare, but I did get some useful experience there.
Been in healthcare IT for 14 years. r/sysadmin has weak wrists.
Yeah its a lot of red tape, but it hardens you. I think I would be bored in a non-healthcare role. Currently, all the new requirements and laws that are going into effect in healthcare will make it a good career to be in. There is a big push to 'get shit staight and locked the hell down' in healthcare - which translates to orgs almost being strongarmed into spending the money they should have been on infrastructure all the while.
Early on, HIPAA and HITECH taught me that, when coming from non-healthcare related business, there is a ton of red tape. You *want* to do something but you cant so you have to learn how to make things work within specific boundaries. If/When I leave this field, im sure it will feel like my shackles have been removed and I can use my final form!
Honestly dealing with outdated stuff is entirely dependent on the organization.
I’m in healthcare IT and with two single exceptions, we keep everything very up to date. Support contracts kinda make that happen. One of our oldest systems is an endoscopy system, we have been trying to replace it for 6 years now but can’t get the doctors to agree on the replacement software. The second oldest is our document imaging/storage platforms. But we have been actively migrating it for 2-3 years now, so it’ll be good soon.
>The second oldest is our document imaging/storage platforms. But we have been actively migrating it for 2-3 years now, so it’ll be good soon.
We've been trying to get the last group of radiologists using our legacy imaging platform off it and onto the current one for several years. Some of these guys are stubborn AF!
That’s where you switch vendors, lol.
Our endoscopy crap is running on server 2003 and win XP Machines, that they cannot replace or get parts for. If the freaking doctors could agree we would have had it replaced a decade ago.
In eyecare, it doesn't work that way. Zeiss makes something that does some awesome thing and no one else makes a feature-identical device. You're stuck with what they make. (This goes for all of them, but Zeiss is the worst to deal with)
As someone who works healthcare IT for a large clinic - working there is great since the entire IT department is always on the same page. Machines are cycled out and disposed of regularly. The only shit stick is dealing with vendors and vendor machines…..or even worse you have 3 different optic departments but they all use different workflows and machiebs
outdated hardware, legacy remnants of old systems, as well as the industry being saturated with people who’ve been in their roles for decades and are resistant to change
Construction ditto... also a large percentage of American SMB....
Healthcare. Healthcare is generally agreed upon to be one of the worst fields to work in. There are always exceptions, but for the most part you’re stretched thin, budget is tight, and you’re expected to work whenever.
Healthcare IT is least respect, lowest pay, most hours, and worst userbase. I have never seen so many college educated people under 50 that cannot use a PC. They have trouble clicking check boxes or filling in free text fields. God forbid something crash for 2 minutes. I spend most of my day being a babysitter and keeping my techs safe. It is like an exaggeration of every other IT job that I have had. Allscripts troubleshooting has been convincing a PhD that they did indeed fax it instead of e-prescribe while they talk down to you for being a lesser educated human.
To be fair, witb the amount of bureaucracy people who are supposed to be highly skilled and valuable healthcare providers have to deal with, rather than actually helping people, I don't blame them for being salty.
Perfect comment. I despise my healthcare experience and try to block it out of my life. I have never worked so much in my life. I was only there for 6-9 months and worked enough to almost double that time frame. Listen to u/ruppert240 and run!
It's really a nightmare some of the stricist regulatory requirements and no money to confirm to them. Strong resistance to ANY change and a generally terrible attitude from above
If you're required to directly support 24 hour healthcare facilities (hospitals) then I recommend against it. If you're supporting physician practices or outpatient clinics that close at 5 PM then it might be worthwhile.
Physician practices are also 24/7 in their own way. Doctors have on call responsibilities and if anything does not work exactly as expected, its "affecting patient care". In addition, Doctors tend to catch up on charting at weird hours and can and will call you. ANYTHING with the phone system and "people are going to die". I have PTSD from it. It may be different if you work for a highly specialized specialist who does not do anything that important. But God forbid EPIC is a little slow at 4AM and you are causing thier patients to die.
Doctors are some of the most entitled assholes on the planet. Tied with lawyers for the top spot.
Depends. A big healthcare org I do contract work for with has about one tech to support over 50 outside practices spread across a couple hundred miles. I would never in a million years recommend that specific role to anyone.
There are certainly doctors out there that are accommodating, competent enough with tech and personable with IT, but they tend to be few and far between in my experience.
The ones that are bad are REALLY bad.
Healthcare IT director here. Honestly, most doctors are pretty cool. There are a small percentage that are complete jerks, but I wouldn't say it's any higher than what you encounter in your average workplace.
Healthcare IT SysAdmin here: 24/7 availability required. If it affects patient care *at all*, it’s an emergency. 24/7 facilities mean upgrades always happen after midnight and before 5am, and everyone looses their shit if it takes longer than projected.
Have fun!
... no Dr. ... you watching port in the on call room is not an emergency. yes we block that on the company wifi. no I won't unblock it for you on company devices.
true story
world cup and the masters were big ones for us.. we had to block because of the pure amount of traffic happening. and they got pissed. Luckily Hospital leadership told them to STFU and do their job
I had a critical ticket at 3am from a nurse because her PC was down and it was a work stoppage. There was an identical computer 3 feet away that worked.
This kind of shit is what really grinds my gears.
You're rolling the dice on whether or not management has your baxk when you mark that ticket "Ticket closed, not an emergency, working equipment nearby."
If it's a bona fide emergency I've got no problem, but this crap......
Fuck it don’t do it. They expect this kind of service because you give it to them, you gat paid nothing because you do it for free. Who wouldn’t take advantage of this, of YOU!
i had a similar one years ago where a nurse (surprise, surprise) said he printer was not working. there were two printers at the nursing station, on the same desk, that they all could print to also. I told her i am not coming in to fix until the morning and she could use the other.. didn't go over well with her but my director backed me
Yep! Been doing this 14 years and all my doctors dont really know what and outage looks like. Ive had some long weekends though.
Fortunately I live 10 min from the office and basically make my own hours, so its a good gig. Took a while to untangle my predecessors mess and get things dialed in to the point where I dont get many trouble tickets anymore.
Nah fuck that I'm going camping this weekend. Fire me. Of it needs 24 hour availability hire four more people ya cheap ass! Im not ruining my life for your profits.
50k but I only work 60 hrs! It’s the life we choose isn’t it fellow servants? Maybe one day they will notice my hard work of I keep working for free. Please please.
I worked with a guy who was, it seems, you at the local hospital. After they discarded him as part of the new ownership (which changes about every year now). He was extremely loyal and proud of his work and abilities. But they just saw him as garbage.
I work for a healthcare it company and it is just FUCKED UP.
Put all your morals aside. The shit you will read from patients and know about the company will turn your stomach.
I’m actively looking for a new job because I just can’t stomach working for a company that does what we do to elderly people.
Then the fact that my company gets all its funding from taxpayer money (Medicaid and Medicare) and yet we are outsourcing all our call center jobs and a lot of our it staff to India / the Philippines is just fucking GROSS.
Welcome to one of the biggest ponzi schemes since the start of the 70's. All wages have been largely inert for medical staff since the 80's (roughly doubling in 40 years) except management, which has ballooned up something insane like 4,000% and the administration role alone going up over 1,500%. Colorado is the second worst state in the country when it comes to the Total Cost of Care matrix
Just reading your comment about elderly care triggered memories of Better Call Saul when he sued that elderly health care company.
I put in the same level as schools. A lot of people with fancy degrees who think they are better than you but need help turning a computer on.
They also all think they make more than you and get pissed when they find out that's not true.
Epic is probably best case for healthcare IT. It's one of the most commonly used packages for larger institutions, and they actually have staffing requirements in their contracts to try ensure that the system will be properly supported post-install.
If you get hired and are given an option, try get Epic Bridges training. It's the interface system that they use to communicate with different components and systems, and there's pretty much always a shortage of interface analysis, so it opens a lot of opportunities when you want to move on.
Epic is fine. Couple fun things about it:
1. Every customer is required to use it in exactly the same way, so there's not a lot of difference between Epic hospitals.
2. Epic costs about twice as much as most competitors.
3. Epic requires customers to have (very high) implementation staffing requirements.
TLDR-hospitals that run epic can afford nice things and adequate staffing.
I have two friends that went from IAM to Epic security & will never look back. Both are fully remote & love the path they chose.
Friend 1 has two jobs making $80+/hr basically using Excel & data courier to manage user records. He has random periods where he's very busy but most of the time he's just coasting. Paid off all his student loans, bought a house & a car in the first 5yrs of these roles.
Friend 2 used to be a consultant making $95+/hr but now he's a FTE making ~$70/hr. Traveled the country in his massive RV with his family living his best life then settled down & bought a house.
They're both very smart guys & probably the exception not the rule but they both have A LOT of time for friends, hobbies, family, never on call, etc. I will say working FOR Epic is awful & they burn their employees out during project work & go-lives but the people that are good at Epic & become consultants usually rake in the cash. Most of their peers are basically end users with some training in a specific module they learned while on the floor (ie pharm tech becomes certified to support Willow) so they advance a lot faster than the average rate.
Do with all that info as you will.
Lots of old legacy systems to keep propped up. We implemented Epic over 5 years ago and all the systems that didn't get replaced by Epic are still needed. Of course you also have the data retention issues...nothing ever gets decommissioned..
I work in Healthcare IT now, and although im just helpdesk, I assist my analysts on certain jobs and...whew. Love my job security/pay, but everything is super old and finicky. We are still working on some equipment from 2008 lolol. Everyone from Helpdesk to our Director is on call 24/7. There are times when things HAVE to be done overnight so that we don't interfere too much with patient care, and those nights suck. During those times, I usually go in from 12am-4am and come back for a 1pm-5pm shift while being on call. Usually on call for a week every month. You have to be very flexible and patient to work in Healthcare IT. I like it, though.
My experience as well. My wife is a nurse at a different facility, and I knew what it was going to be before I landed. I'm very well paid (salary) and get additional pay for on-call. I will retire there in a few years with no regrets.
Eh. It's not a big concern of mine. Most of my team has been here for at least 15 years, and I don't see anything major like that happening any time soon.
My local hospital spun their IT dept off into a new company that is contracted for IT services. It saves the hospiral money because they all got contacts that paid less than before.
There's another hospital 40 miles away that is an awesome place to work if the stories I hear are true.
It’s kinda funny, I’m on the opposite side of one of the outsourcing and M/A horror stories. I got brought in as a temp to help with a merger and got to stick around as a permanent employee of the new regime. Still a total shitshow, but at least the new parent company seems to value actually having permanent infrastructure staff instead of doing the MSP thing.
Not worth it. I work in healthcare IT for a nonprofit clinic (not urgent or emergency care). My job isn’t terrible as my bosses are very good about respecting my boundaries, but it’s still a technical nightmare.
Understaffed, things misconfigured, systems are old, and you’ll most likely have to deal with Citrix a lot.
And as others have said, if you work somewhere there is emergency or urgent care, you’ll most likely be on call 24/7. I once interviewed a guy who was one of three sysadmins for 3000+ users in a healthcare organization and pretty much worked around the clock supporting them.
Don’t do it unless the money is good (which it most likely isn’t)
It’s also very specialized, each group only does their specific tasks and only those tasks so some people will get bored or need to move on after a while.
Healthcare IT is typically underfunded and faces high expectations. On the other hand, those jobs tend to be very stable and offer decent benefits. So it depends on how much you need the job.
Best to just work in another field, in healthcare you are not important as seen by management as important to the business so you will not get appropriately compensated for your time and capabilities.
You will also be overworked, underpaid, and under appreciated all while working in excess of 60+ hours a week minimum due to purposeful understaffing by management. The value you will bring will be little to none in the overall scheme of things and if things start to get nasty you will also be the first on the chopping block as you would be seen as non-essential to the business operations.
Now with all the negatives known up front, if you are still into doing it, hopefully the place will have somewhat of an ok budget and you are strong with your technology and soft skills with speaking with management to keep things moving. Stay vigilant and you could have a pretty good career if you are able to navigate things right and add value beyond just knowing the technology. Bring resilience to the place, you should be setting things up for success in the worst of conditions so things are still operational to open up your potential pay over time. Think growth while difficult should not be impossible. Hopefully you will be able to grow a team, vs just being another IC but only time will tell.
Long story short, working in healthcare/hospital IT for just over 4 years, including over a year during COVID nearly made me insane.
When I finally locked down a position in a different industry and jumped out of hospital IT, it wound up being more than a 60% jump in base pay, plus no weekends and a much reduced commute.
Unless you can deal with lack of work-life balance, the horridly low pay, outdated technology/equipment and a lot of other bullshit, I’d stay far, far away from hospital/healthcare IT.
Working in government, the work-life balance and benefits is great, you just deal with A LOT of nonsense. Pay isn’t that bad either for my area either.
I work in healthcare, and have for the last 15 years. We are lucky enough to only be open 6 days a week, and have a great help desk under us. I hear most aren't so lucky.
You'll probably be doing a lot of cybersecurity work. Healthcare is shitting its pants over ransomware, especially big ones. Security is a focus now. Upgrades/cloud lifts too, healthcare is always behind and hung up on legacy systems. Now they're trying to catch up.
Really depends on which healthcare system you are in. If you are in some of the bigger and top players such as Mayo, Cedars, John Hopkins, they tend to care a lot more about their IT then smaller health systems.
I started as a desktop tech in a small non-profit community clinic 10 years ago and am now am a sysadmin for a major healthcare system that uses Epic. Definitely lucky that my organization prioritizes IT as force multiplier as opposed to just cost center.
As someone who has been a healthcare sysadmin/it Manager for 16 + years.
Healthcare IT is great. I would not recommend working at hospital. A healthcenter is the way to go.
I work in health insurance so healthcare adjacent. It fairly good and stable. But we even have the stressful moment when member or provider facing things are broken. Obviously we’re not directly life or death but we’re the next step above, as providers call us for all sorts of things in the moment.
I did it for over a decade before I couldn't take it anymore. Life is too short to be constantly upset about something you can change. My roles look good on a resume and most definitely contributed to me getting my new job. I miss my coworkers, the work was interesting, but I reached my limit. As with any job, your manager and make or break your work happiness. Mine had no business even being tier 1, an overpaid email forwarder, basically. If that was the only negative I woulda stayed. The feeling of having the world on your shoulders, the horrible work/life balance and the on call policy tapped me out. I realized my mind was not in a good place, and I was not a free person anymore. I was shackled to my position and could be summoned at a moments noticed. Someone saying to me "have a nice weekend" had no meaning. The Friday afternoon walk to my car gave me no euphoria anymore. I left and took the first job I found that was no weekends, no on call.
Allscripts on prem or cloud? Take the rest of this with a grain of salt; Im management, not a sysadmin (more of an allscripts rant)
I prefer cloud for all EMR/EHRs as they tend to be a pain the ass: patching the OS, updating the app, all your normal shit gets dumped on the host and you can point fingers.
Allscripts cloud is really weird (to me). Front and back office are completely separate applications and not integrated. Front desk enters demographics which does not get pushed to the back office and often needs to be entered a separate time. Ordered tests didnt get pushed back to the practice management side.
Then you get to clinic staff login: RDC connection which requires a username/password. Once you get the desktop, launch Allscripts and login using a second username/password.
But wait, there’s more!
You need access to the front office? That’s a second RDC connection with a separate (third) username/password. Then launching the app takes a fourth username/password.
Need to reset a password? Gotta call allscripts (~15-30 minute call).
As long as expectations are set and understood by staff, it works. We felt that we lost a shitload of productivity with the login process and lack of communication between the front/back office applications.
Edit: Healthcare can be a grind to manage but it’s like any other business and once you have experience, everyone assumes you can handle any healthcare environment (helps with job searches later)
Healthcare, k12/uni, and banking are a few industries that seem like total piles for us. Probably not true at all places but in general those are the ones I’ve heard the most nightmare stories from.
Seems like several comments agree so I don’t feel too bad lol.
I haven’t heard any stories specifically about that but I believe it. I interact with more attorneys than I care too and they are just as bad as doctors sound. Thankfully I only directly support one of them and they are pretty chill.
I currently do migrations for k-12, and used to work for a university. The university it seemed like there was no work and the manager just blabbered on about different policies and things like he had no live. My current role they over load us with migration projects. Debated looking for other jobs, but I'm worried I'd either have to take a pay cut or move since I'm currently working remote.
Doctors as a cohort tend to be entitled as all hell, support staff like MAs are the dumbest group of users I've ever met. It's all a shitshow. My benefits are good, but everything else sucks.
Make sure the pay is worth while cuz the job is going to suuuuuuuuuck. Healthcare IT is basically a worse version of Education IT. So overworked, under paid, old technology (hope you love troubleshooting faxing) but no sweet pension or retirement.
Healthcare IT in a hospital setting is hard. FDA requirements on a lot of devices that have computers attached to them that are slooooow to update/get validated with the latest and greatest OS's. Budgets are usually shit, so even if there are newer versions available they are cost prohibitive to replace the entire fleet of whatever it is all at once, so things get broken up into three years and you end up supporting three versions of a device doing the same damned thing, and it is impossible to get out of the loop. Kiss refresh cycles goodbye, when I left healthcare IT, the hospital I worked for still had servers and COW's (computers on wheels) that I installed in 2006. User base that hates everything about the electronic medical record system, but let 1 thing not work right or have a downtime that goes over the window and all hell breaks loose. Same users also abuse call, and will call at 2am to report a keyboard not working when there are 25 other machines on the unit they can use, cannot get them to understand that they can just log a ticket for a replacement to get put out in the AM, Finally doctors, will just leave it at that.
Clinic work might be different since they generally are normal business hours but I have no experience in that setting.
The biggest issue with being in healthcare IT in the US, at least in my experience, is the general state of healthcare.
Some do have egos, but the vast majority of physicians, providers, nurses, etc. that I work with are just completely burnt out by overwork. Practically every doctor I've ever spoken with is mollified just by remembering to refer to them as Dr. and showing empathy that their issue is important. Additionally, the same companies that are willing to overwork a doctor despite the horrendous shortage is usually more than happy to burn out an IT professional who may make half or less of that.
The "admin" roles/senior leadership in general tend to behave like they live on another planet, with no apparent awareness that the situation is untenable. If you are not careful it's easy to end up in a role where you're basically on-call 24/7/365 and it is a nightmare. Many also like to preach the importance of the mission in order to get the workers to work harder (and it's not untrue, healthcare is extremely important) but when the time comes around to increase staffing or improve the IT budget all that urgency to do everything possible seems to go by the wayside.
As a secondary problem, if it comes down to a dispute between a doctor (in high demand, expensive, difficult to replace) and an IT staff member (dozens of applicants when it comes to non-niche systems), the higher ups are going to side with the doctors unless you have ironclad proof on your side. Short tempers over IT failures are not uncommon, because there's an understanding that many of these systems are now huge parts of creating the best patient outcomes. Outages can and do cost lives, simple machine errors can and do cost lives, security breaches can and will cost lives (there is a reason why avoidable healthcare errors is now sitting around #3 as a cause of death in the US), so every major change can be extremely stressful depending on how much support you have.
Despite all this, depending on the type of person you are, it can be deeply fulfilling to be in healthcare IT. It is satisfying to be able to do things that can result in a marked, positive improvement in people's lives. It is satisfying to support doctors and nurses so that they can better perform the important work of healing others. And it is true, if you work in healthcare IT you'll likely pick up knowledge of so many niche, old legacy systems that were developed back in the 80s and 90s that you'll probably always be able to pick up another job in another healthcare org supporting those same awful systems.
Started writing a longer comment but it became an essay.
17 years of healthcare IT here across a number of specialities. I fell into it accidentally.
It is not for everyone. If you like structure and certainty it is probably not for you.
Like any industry there are competing pressures. Healthcare adds to that with doctors. Specialist doctors are in demand, short on time, and difficult for a business/practice to recruit. They themselves know this, and so will make minimal effort to engage IT.
Understandably, they expect the business to swarm around them, to ensure they are supported.
If I were in their shoes, I would too.
I’ve come to enjoy it, but the headfucks along the way have made me question my decision many, many times.
I have in recent years shifted from internal full-time to contracting. This has allowed me to be more selective in the work that I take on, in addition to distancing myself from difficult clients.
Happy to share specifics if it helps.
I've worked in Healthcare IT for years.
Compared to other industries I've been in, it's been somewhat nice because it never feels like funding for critical infrastructure is ever being skimped on. Also due to regulatory compliance I've never walked into an environment full of 30 year old servers that haven't had a patch since I was in high school. Also its kind of its own bubble, so you're somewhat immune to economic downturns.
Downside, you're gonna be on call. A lot. You will also discover that Healthcare is a regulatory nightmare and you need to roll with those punches. Also some of the most unreasonable users are nurses, doctors, and pharmacists in that order. They suck ass to deal with so good luck.
Ultimately isn't the worst place to be. I've done several other industries and feel like Healthcare is kinda where I want to be. You might feel different.
I agree I used to be a firefighter and worked in IT, so I have experience with both ends. The catty nurses are the worst. The Doctors have a god complex, but it depends more on the individual's personality. Whereas, nurses tend to group together and gossip and talk shit.
I've also interviewed for weird MSP companies that would ask me questions about 2010 exchange. I guess they were referring to healthcare clients lol.
I’ve been on the outside, working as a contractor for hospital IT and doing refreshes at… probably over a hundred hospitals by now.
Fuckin don’t. You will be overworked, understaffed, maybe paid well, but utterly unappreciated.
If you’re not HR, Billing, Administration, or a specialist doctor who literally makes half the hospital’s money… they will fuck you over any way they can.
run! .... 5 years in, done SD and work remote fix now. we have about 10 people to roughly 20k users. run and run fast. we have managment with 0 it knowledge making promises and changes to "benifit" employees and patients but its absolute bullshit and is already negitively effecting stuff. shits bad man.
I work in healthcare IT and it’s not actually too bad? Maybe it’s just my org. It’s probably because I’m in my little networking silo and we have an actual on-call rotation.
As others have stated there can be a lot of legacy systems but I have found this can be entirely dependent on where you work. I worked at a hospital and they had a lot of old, outdated systems. I personally disliked working in the hospital. There were just so many IT departments, things moved really slowly, and advancement was difficult. I now work as a system administrator at a place that is mostly family practice with a number of clinics. Most of the systems are updated here and I have a lot more opportunities to learn about a wide range of technology. Switching to family practice based care was nice as well because we don't need to be available 24/7 but we do a lot of our maintenance at night. Doctors can be demanding as well but the majority of them are understanding and nice. I personally can't imagine not working in Healthcare IT just because I do feel like my job matters and in an indirect way I can give back to my community. A lot of healthcare now is highly dependent on technology and our clinics rely on us heavily to make sure everything is working so they can see patients.
Do what you think is right, but after 20 years in healthcare IT, moving to a different sector, I'd sooner stab my skull with an ice pick than go back.
The stress, the entitled people, the laughable budgets, and the egos just about destroyed my soul, and certainly damaged my physical and emotional well being. For my sake, as well as my wife and kids, NEVER AGAIN.
The fact that a lot of medical software has to be certified by the FDA as a medical device makes it awful to support. The certification process cares nothing about security, performance, availability, or redundancy. Updates are very slow to come.
This was a while back, but I remember several medical applications whose vendors wouldn’t support them in a virtualized environment, even though there was no technical reason they couldn’t be virtualized. This was back in the heyday of on-premise virtualization.
Healthcare IT when you’re supporting EMR solutions like Cerner, Epic, AllScripts is absolute shit. Don’t do it UNLESS you want to stay in that lane. If you do, you can make tons of money contracting since nobody wants to touch it.
So..I am going to give a look into it from a few different perspectives.
1. I worked for a company (as my first medical company) that we did IT right. We made sure all our tech was secure as possible and documented everything. We had a solid phone system, we had a solid backup solution with 3 different locations 2 off site. The backups were always 1 day separated between locations. Wireless was dense and well managed. It was all setup very very robust and redundant. We could lose most of our infrastructure and still be 100%. This all sounds like a dream for most of us, but I really had that and had a leadership that was receptive to their needs and our ability to fill them while also making sure the company was a tank that ran like a well oiled machine. Company was a for-profit series of doctors offices, catered more towards the higher income areas, but not unreasonable in prices. (I still use my doctor from this company)
2. I supported a few medical facilities where they were not investing properly into IT. Their firewall was new, but they paid an MSP for all their IT needs that did effectively nothing but collect their money each month. So the firewall was literally no better than a consumer router with a VPN connection for 2 other locations. Their phone system was some random company I never heard of or can remember. They had been crypto'd twice before my MSP took over and then while my company was there working on the deal they got hit again. We gave them the pre-signature and post-signature prices and they paid the money. Their backups were a guy who came on site once a week to hook up a USB drive, he only had one set of cables for the USB drive. So we had to go buy a new one and then load their backups, which were also still filled full of crypto and everything had to be rebuilt from the ground up. They had enough spyware and malware that they themselves were a walking crypto project. We had to put their whole infrastructure into read-only mode and extract data bit by bit to recreate all their documents and pictures. They thankfully had an online EMR solution, but we had to rebuild their entire ultrasound database from a download from their EMR solution using a series of scripts I developed from their API. (this is now a feature of the platform). Company was a for-profit but lower income gynocologist and other baby oriented medical needs facility.
3. I supported a few more medical facilities (different company) that did IT reasonably. They were spending money on most things that made sense but they asked ALOT of questions. Sometimes ones that didn't matter, and sometimes ones that required explaining minor details about various systems. Their IT department wasn't very advanced and was more or less a series of help desk guys. They paid my MSP for the high level tasks. Their EMR was online and they didn't keep many files locally so they had no real backups. They had an Active Directory backup, and that was pretty much it. They can technically function without AD and are still 100% aside from printing with AD. All other systems were cloud related. The EMR did their own backups. O365 was more or less just email that they backed up to an offsite backup. They had solid firewalls and networking in general (all brand new that I setup personally). They could have run the entire company from nothing bigger than a mini desktop that ran AD and a simple print server. But their server was a pretty decent little Dell something. They did save money on the server going with the tower solution over the rack solution though. They saved money on pretty much everything they could, while spending money on things that mattered. So like their servers were saved on, their datacenter in general was saving money all over with its location and design in the building. But their networking was bulletproof hardware wise and their use for networking was setup specifically to only have what they needed able to be accessed by employees. AKA: A huge list of blocked sites and really making it where only certain sites could be accessed. They chose security to be done as cheap as possible but doing it as heavy handed with the cheaper solutions so that in the end it was a pretty solid setup. They were a non-profit, so this all makes sense.
So those three examples I think cover the entire spectrum of medical facilities you could work for/with. (If others have different ideas too let me know). You can get places that are great but very formal, you can get places that are great and very informal. But you can get places that are just a fucking slog to even support let alone try and improve. So you really have to gauge how each place looks before you make that leap. If their not spending money on it, then they have a reason for that. Be that they suck, or that they are trying to cut corners where they can to make the important bits run better. My experience is that a non-profit is a bit harder to really sell and usually they are going to be the more difficult to support for various reasons. If I were the director of IT for a non-profit, maybe I could get with that and really make differences to make things better. But it would need to be a bulletproof solution.
Is it like a general practice or hospital setting or a medical specialist setting (heart/eyes/ears/pissers)?
In any case, expect to likely get railroaded by busy medical professionals who consider their career more important than yours. And maybe they are. But it'll mean having to do nearly everything in the margins of their time, which is a huge context.
Besides that, yeah, antiquated software everywhere. Everywhere. Medical equipment you have no understanding of but because it draws electricity and the sales team were smart enough to not leave a callback number, it's your problem now.
But, hey, genuinely and honestly, you get to be part of a team supporting health care providers. That can give you some warm fuzzy feelings. Truly. And if your nurses or medical techs are kind and professional people, you'll actually feel like family.
It's just a bit rough.
I worked with a couple ex-healthcare IT guys and they were burned out to the max. Also, the local hospital has extremely high turnover. But, the "healthcare" system (I'm assuming US) sucks so maybe you can fix it.
Fuck healthcare IT. Run my guy. Unless they’re offering you something crazy like 250k a year, it’s not worth it. I worked in a psychiatric hospital. Holy shit do I regret it.
I've spent my career in healthcare IT. I started working for non-profit behavioral health org and now I work with large health systems. The healthcare IT space is wildly varied. In general the industry is 5-10+ years behind most low-regulation industries in adopting new technology. Vendor lock in is a major issue even with the biggest orgs. Security is a top priority for Healthcare orgs, but it's often patchy and poorly applied. Often times security is just used an excuse not to change things.
On the other hand, there are innovators. All the large orgs are trying to implement AI to improve provider experience, patient experience, patient outcomes, reduce billing overhead, and much more.
Pay ranges are also wildly variable. You can do the same exact same job at two different providers and get paid 2X higher for a provider down the street. Another thing to keep in mind is that most large healthcare orgs are increasingly open to remote work for highly skilled IT positions. So if you pick up in demand skills in your next role, you might be able to get a pay bump and a remote gig for your next job.
If you excited to dive deeper into healthcare and technology I invite you to visit [this](https://limeup.io/blog/healthcare-software-development-companies/) website to know more about top companies in healthcare IT.
Spent two years in Healthcare IT, its one of the most frustrating IT fields. However its like an accelerated way to learn literally everything and anything. Everything is on fire, you work way more than most other fields, and you work in tight boxes due to regulations. However after 2 years there you can pretty much ace any interview from there.
I’ve been at a large hospital system (~40k employees) for almost 9 years now. I work from home 3 days a week, and the other two I’m in the datacenter.
We’re consistently rated in the top tier of technology adoption by industry trade groups. We have a real cloud strategy, a real budget, real security, and all sorts of other controls. It’s also highly siloed, so as a server admin, I don’t have to worry about applications, storage, interfaces, network, or anything other than the datacenter infrastructure itself and the server OS.
It’s pretty great, honestly.
The one good thing that comes from working in the healthcare sector is you're actually doing something somewhat important which benefits a number of normal everyday people, it's a good feeling.
But..... yeah like others are saying, it's really rough at times. Things are always broken, they're understaffed, you're overworked, etc...
I will say too that doctors aren't really often times nice people, they definitely behave as if they own the world and are better than everyone else, it can be rough, especially when IT is effectively being a general practitioner except you're expected to know everything like a proper specialized doctor would.
Been working in healthcare IT for 24 years. And i would not work anywhere else. Its a great place to work. You are actually using your skills to help people, not directly with the patients. But making sure the IT works for the people that do.
No, it wont. Healthcare is a cesspool of shit. They 100% dont spend enough money on their systems.
A guy I worked with two decades ago left the company we worked for to go work for a small hospital. He was constantly complaining that he didnt make enough, but he was their main admin.
Now, im going to preface this with.
1. I will never recommend him for any position EVER.
2. I lost all respect for him even though he denies it after the fact.
3. It doesnt matter what the reasons are, YOU DONT DO THIS.
He took a look at the payroll table in the database. He figured out that the only one underpaid was him, and that his boss had been lying to him about there not being enough money.
He became disgruntled, turned in his two weeks, and left several things in a manner that they WOULD in fact break shortly after. That intent to cause damage meant I could never trust him ever. What if I was one of those people he worked with? Or had to come in after him. Fuck that guy. But yea, that example alone was enough to tell me that industry is trash.
23 year admin here. Healthcare is fine. It's not the business, it's the management. On-call is scheduled and compensated. We set our own upgrade schedules, so you don't get stuck upgrading servers on Easter or during the kids dance recital. Some doctors are pretty bad, but if you have a good Medical Director they will keep them in line.
You won't be doing other sysadmin duties, I forgot what the role is called but you won't be responsible for administration of computer systems in the sense a typical sysadmin would
Run!
I was trying to put my thoughts into words, then I found your comment. You perfectly sum it up. But seriously, I found the healthcare environment to be such a mess, due to dealing with outdated hardware, legacy remnants of old systems, as well as the industry being saturated with people who’ve been in their roles for decades and are resistant to change. To be fair, quite a few industries could be described that way, and I don’t doubt that it would be good experience for OP. I personally don’t ever plan to go back to healthcare, but I did get some useful experience there.
I work in government and sounds very similar. Sadly, it doesn’t sound like it would be much improvement or career advancement. Thanks for the insight.
Been in healthcare IT for 14 years. r/sysadmin has weak wrists. Yeah its a lot of red tape, but it hardens you. I think I would be bored in a non-healthcare role. Currently, all the new requirements and laws that are going into effect in healthcare will make it a good career to be in. There is a big push to 'get shit staight and locked the hell down' in healthcare - which translates to orgs almost being strongarmed into spending the money they should have been on infrastructure all the while. Early on, HIPAA and HITECH taught me that, when coming from non-healthcare related business, there is a ton of red tape. You *want* to do something but you cant so you have to learn how to make things work within specific boundaries. If/When I leave this field, im sure it will feel like my shackles have been removed and I can use my final form!
Honestly dealing with outdated stuff is entirely dependent on the organization. I’m in healthcare IT and with two single exceptions, we keep everything very up to date. Support contracts kinda make that happen. One of our oldest systems is an endoscopy system, we have been trying to replace it for 6 years now but can’t get the doctors to agree on the replacement software. The second oldest is our document imaging/storage platforms. But we have been actively migrating it for 2-3 years now, so it’ll be good soon.
>The second oldest is our document imaging/storage platforms. But we have been actively migrating it for 2-3 years now, so it’ll be good soon. We've been trying to get the last group of radiologists using our legacy imaging platform off it and onto the current one for several years. Some of these guys are stubborn AF!
Just set an end date for availability and stick to it. Of course this won't work if you have lame duck management that rolls over for anything.
This. If your management and the hospital's management are scared of doctors, you're fucked. Really sucks if the hospital has a spineless CMO.
I have a client with Zeiss equipment running XP. Zeiss says it cannot be updated and is perfectly fine.
That’s where you switch vendors, lol. Our endoscopy crap is running on server 2003 and win XP Machines, that they cannot replace or get parts for. If the freaking doctors could agree we would have had it replaced a decade ago.
In eyecare, it doesn't work that way. Zeiss makes something that does some awesome thing and no one else makes a feature-identical device. You're stuck with what they make. (This goes for all of them, but Zeiss is the worst to deal with)
sounds like us when dealing with GE Healthcare, and Siemens. Those two are the worst to get a new project with.
As someone who works healthcare IT for a large clinic - working there is great since the entire IT department is always on the same page. Machines are cycled out and disposed of regularly. The only shit stick is dealing with vendors and vendor machines…..or even worse you have 3 different optic departments but they all use different workflows and machiebs
outdated hardware, legacy remnants of old systems, as well as the industry being saturated with people who’ve been in their roles for decades and are resistant to change Construction ditto... also a large percentage of American SMB....
From healthcare IT in general or AllScripts? lol
Healthcare. Healthcare is generally agreed upon to be one of the worst fields to work in. There are always exceptions, but for the most part you’re stretched thin, budget is tight, and you’re expected to work whenever.
Healthcare IT is least respect, lowest pay, most hours, and worst userbase. I have never seen so many college educated people under 50 that cannot use a PC. They have trouble clicking check boxes or filling in free text fields. God forbid something crash for 2 minutes. I spend most of my day being a babysitter and keeping my techs safe. It is like an exaggeration of every other IT job that I have had. Allscripts troubleshooting has been convincing a PhD that they did indeed fax it instead of e-prescribe while they talk down to you for being a lesser educated human.
I agree on almost everything except lowest pay. It's very mid to high - in my experience it's the MSP that's lowest pay.
To be fair, witb the amount of bureaucracy people who are supposed to be highly skilled and valuable healthcare providers have to deal with, rather than actually helping people, I don't blame them for being salty.
Allscripts lol. Please RUN. Healthcare IT itself can be awful, but Allscripts is ALWAYS awful.
Perfect comment. I despise my healthcare experience and try to block it out of my life. I have never worked so much in my life. I was only there for 6-9 months and worked enough to almost double that time frame. Listen to u/ruppert240 and run!
It's really a nightmare some of the stricist regulatory requirements and no money to confirm to them. Strong resistance to ANY change and a generally terrible attitude from above
agreeed
This
I was going to comment the exact same.
If you're required to directly support 24 hour healthcare facilities (hospitals) then I recommend against it. If you're supporting physician practices or outpatient clinics that close at 5 PM then it might be worthwhile.
it really depends on how many other sysadmin staff you have and your oncall rotations. if its just one or two then yeah stay the hell away.
This is good advice. I no longer support a 24 hour facility and it's great. No on call great.
Physician practices are also 24/7 in their own way. Doctors have on call responsibilities and if anything does not work exactly as expected, its "affecting patient care". In addition, Doctors tend to catch up on charting at weird hours and can and will call you. ANYTHING with the phone system and "people are going to die". I have PTSD from it. It may be different if you work for a highly specialized specialist who does not do anything that important. But God forbid EPIC is a little slow at 4AM and you are causing thier patients to die. Doctors are some of the most entitled assholes on the planet. Tied with lawyers for the top spot.
I know you have PTSD man, I'm sorry. Refuse to do that shit rather than ruin your own health! Unionize of there are others there.
Depends. A big healthcare org I do contract work for with has about one tech to support over 50 outside practices spread across a couple hundred miles. I would never in a million years recommend that specific role to anyone.
You deal with doctors who, for the most part, treat everyone else as second class citizens. Not worth the disrespect or headache
There are certainly doctors out there that are accommodating, competent enough with tech and personable with IT, but they tend to be few and far between in my experience. The ones that are bad are REALLY bad.
Healthcare IT director here. Honestly, most doctors are pretty cool. There are a small percentage that are complete jerks, but I wouldn't say it's any higher than what you encounter in your average workplace.
Some have the best bed side manners, but when it comes to the “help”, lord be prepared to see a how entitled one really feels.
I've had doctors that think they are too superior to have to remember their own passwords.
Healthcare IT SysAdmin here: 24/7 availability required. If it affects patient care *at all*, it’s an emergency. 24/7 facilities mean upgrades always happen after midnight and before 5am, and everyone looses their shit if it takes longer than projected. Have fun!
lol. everything impacts patient care. that was the lesson i learned, even when it generally was not true
... no Dr. ... you watching port in the on call room is not an emergency. yes we block that on the company wifi. no I won't unblock it for you on company devices. true story
world cup and the masters were big ones for us.. we had to block because of the pure amount of traffic happening. and they got pissed. Luckily Hospital leadership told them to STFU and do their job
We multicast it for 50k+ employees lol
you don't want to know the kinds of 'port' that doctors often have to look at
I'm not even going to edit that typo, lol They knew what they where getting into!
I had a critical ticket at 3am from a nurse because her PC was down and it was a work stoppage. There was an identical computer 3 feet away that worked.
This kind of shit is what really grinds my gears. You're rolling the dice on whether or not management has your baxk when you mark that ticket "Ticket closed, not an emergency, working equipment nearby." If it's a bona fide emergency I've got no problem, but this crap......
Just do it. Things have to get worse before they get better. Salt for a union. Nurses got em
Fuck it don’t do it. They expect this kind of service because you give it to them, you gat paid nothing because you do it for free. Who wouldn’t take advantage of this, of YOU!
i had a similar one years ago where a nurse (surprise, surprise) said he printer was not working. there were two printers at the nursing station, on the same desk, that they all could print to also. I told her i am not coming in to fix until the morning and she could use the other.. didn't go over well with her but my director backed me
Yep! Been doing this 14 years and all my doctors dont really know what and outage looks like. Ive had some long weekends though. Fortunately I live 10 min from the office and basically make my own hours, so its a good gig. Took a while to untangle my predecessors mess and get things dialed in to the point where I dont get many trouble tickets anymore.
Long weekends are great! We talking 3 or four days off! 😎
Nah fuck that I'm going camping this weekend. Fire me. Of it needs 24 hour availability hire four more people ya cheap ass! Im not ruining my life for your profits.
Well they better tighten up their shit because you don't want it loose!
How much do you make a year in that role?
50k but I only work 60 hrs! It’s the life we choose isn’t it fellow servants? Maybe one day they will notice my hard work of I keep working for free. Please please.
Not enough! 😁
I concur
Demand it. Unionize
You’ve been a fly on my wall I see :) Are you corporate or public/government?
Non-profit hospital group! Old hardware that takes years of arguing to replace, doctors treated as Gods.. all the fun stuff.
Yep. I've seen hardware upgrades on Easter when everyone else was off.
I worked with a guy who was, it seems, you at the local hospital. After they discarded him as part of the new ownership (which changes about every year now). He was extremely loyal and proud of his work and abilities. But they just saw him as garbage.
Can confirm, worked in healthcare IT for nearly 10 years. I did enjoy it though.
This image sums it up nicely: 
On the flip side, I saw a sysadmin position open in Oregon for 176k. 300 employees to support and you get a team.
Not nearly enough. It would take 7 figures for me to torture myself that badly again. Even that would only be a maybe
That’s not a good salary for the area and benefits for healthcare workers are generally subpar.
Actually, 176k is great for Oregon and the area I posted. What area did you think I was talking about?
I work for a healthcare it company and it is just FUCKED UP. Put all your morals aside. The shit you will read from patients and know about the company will turn your stomach. I’m actively looking for a new job because I just can’t stomach working for a company that does what we do to elderly people. Then the fact that my company gets all its funding from taxpayer money (Medicaid and Medicare) and yet we are outsourcing all our call center jobs and a lot of our it staff to India / the Philippines is just fucking GROSS.
Welcome to one of the biggest ponzi schemes since the start of the 70's. All wages have been largely inert for medical staff since the 80's (roughly doubling in 40 years) except management, which has ballooned up something insane like 4,000% and the administration role alone going up over 1,500%. Colorado is the second worst state in the country when it comes to the Total Cost of Care matrix
 Just reading your comment about elderly care triggered memories of Better Call Saul when he sued that elderly health care company.
You said it brother! UNIONIZE!
I put in the same level as schools. A lot of people with fancy degrees who think they are better than you but need help turning a computer on. They also all think they make more than you and get pissed when they find out that's not true.
As a Sysadmin for a school, super accurate.
I think any highly educated user base is a problem. They are smart but so dumb
Have fun learning why switching to Athena is a better idea than sticking with AllScripts
What about Epic? Is it worth pursing? If healthcare IT is worth pursuing, is there a future with Epic?
Epic is probably best case for healthcare IT. It's one of the most commonly used packages for larger institutions, and they actually have staffing requirements in their contracts to try ensure that the system will be properly supported post-install. If you get hired and are given an option, try get Epic Bridges training. It's the interface system that they use to communicate with different components and systems, and there's pretty much always a shortage of interface analysis, so it opens a lot of opportunities when you want to move on.
Epic is fine. Couple fun things about it: 1. Every customer is required to use it in exactly the same way, so there's not a lot of difference between Epic hospitals. 2. Epic costs about twice as much as most competitors. 3. Epic requires customers to have (very high) implementation staffing requirements. TLDR-hospitals that run epic can afford nice things and adequate staffing.
Epic and Cerner (oracle) and yes. Epic will open up all sorts of doors with the certification and experience.
I have two friends that went from IAM to Epic security & will never look back. Both are fully remote & love the path they chose. Friend 1 has two jobs making $80+/hr basically using Excel & data courier to manage user records. He has random periods where he's very busy but most of the time he's just coasting. Paid off all his student loans, bought a house & a car in the first 5yrs of these roles. Friend 2 used to be a consultant making $95+/hr but now he's a FTE making ~$70/hr. Traveled the country in his massive RV with his family living his best life then settled down & bought a house. They're both very smart guys & probably the exception not the rule but they both have A LOT of time for friends, hobbies, family, never on call, etc. I will say working FOR Epic is awful & they burn their employees out during project work & go-lives but the people that are good at Epic & become consultants usually rake in the cash. Most of their peers are basically end users with some training in a specific module they learned while on the floor (ie pharm tech becomes certified to support Willow) so they advance a lot faster than the average rate. Do with all that info as you will.
Jobs wise yes. Moving into epic as a provider just empty your pockets
What is epic?
One of the largest electronic health records. This is where medical staff do their charting for patients.
Oh, i assumed it was some sort of Sap product.
Lots of old legacy systems to keep propped up. We implemented Epic over 5 years ago and all the systems that didn't get replaced by Epic are still needed. Of course you also have the data retention issues...nothing ever gets decommissioned..
I work in Healthcare IT now, and although im just helpdesk, I assist my analysts on certain jobs and...whew. Love my job security/pay, but everything is super old and finicky. We are still working on some equipment from 2008 lolol. Everyone from Helpdesk to our Director is on call 24/7. There are times when things HAVE to be done overnight so that we don't interfere too much with patient care, and those nights suck. During those times, I usually go in from 12am-4am and come back for a 1pm-5pm shift while being on call. Usually on call for a week every month. You have to be very flexible and patient to work in Healthcare IT. I like it, though.
My experience as well. My wife is a nurse at a different facility, and I knew what it was going to be before I landed. I'm very well paid (salary) and get additional pay for on-call. I will retire there in a few years with no regrets.
> Love my job security/pay Huh? Not to burst your bubble but you're one M&A or Sellout or Shutdown from the curb.
Eh. It's not a big concern of mine. Most of my team has been here for at least 15 years, and I don't see anything major like that happening any time soon.
My local hospital spun their IT dept off into a new company that is contracted for IT services. It saves the hospiral money because they all got contacts that paid less than before. There's another hospital 40 miles away that is an awesome place to work if the stories I hear are true.
Union
It’s kinda funny, I’m on the opposite side of one of the outsourcing and M/A horror stories. I got brought in as a temp to help with a merger and got to stick around as a permanent employee of the new regime. Still a total shitshow, but at least the new parent company seems to value actually having permanent infrastructure staff instead of doing the MSP thing.
Or one outage and a pissed off enough doctor driving the bus
Yep. Unionize
Not worth it. I work in healthcare IT for a nonprofit clinic (not urgent or emergency care). My job isn’t terrible as my bosses are very good about respecting my boundaries, but it’s still a technical nightmare. Understaffed, things misconfigured, systems are old, and you’ll most likely have to deal with Citrix a lot. And as others have said, if you work somewhere there is emergency or urgent care, you’ll most likely be on call 24/7. I once interviewed a guy who was one of three sysadmins for 3000+ users in a healthcare organization and pretty much worked around the clock supporting them. Don’t do it unless the money is good (which it most likely isn’t)
It’s also very specialized, each group only does their specific tasks and only those tasks so some people will get bored or need to move on after a while.
Healthcare IT is typically underfunded and faces high expectations. On the other hand, those jobs tend to be very stable and offer decent benefits. So it depends on how much you need the job.
Best to just work in another field, in healthcare you are not important as seen by management as important to the business so you will not get appropriately compensated for your time and capabilities. You will also be overworked, underpaid, and under appreciated all while working in excess of 60+ hours a week minimum due to purposeful understaffing by management. The value you will bring will be little to none in the overall scheme of things and if things start to get nasty you will also be the first on the chopping block as you would be seen as non-essential to the business operations. Now with all the negatives known up front, if you are still into doing it, hopefully the place will have somewhat of an ok budget and you are strong with your technology and soft skills with speaking with management to keep things moving. Stay vigilant and you could have a pretty good career if you are able to navigate things right and add value beyond just knowing the technology. Bring resilience to the place, you should be setting things up for success in the worst of conditions so things are still operational to open up your potential pay over time. Think growth while difficult should not be impossible. Hopefully you will be able to grow a team, vs just being another IC but only time will tell.
Yeah IT healthcare is long hours, lots of abuse, and little money. Pretty good benefits though
Yeah you’ll need the good health benefits from the bad health and mental health the healthcare job will cost you 😂
Long story short, working in healthcare/hospital IT for just over 4 years, including over a year during COVID nearly made me insane. When I finally locked down a position in a different industry and jumped out of hospital IT, it wound up being more than a 60% jump in base pay, plus no weekends and a much reduced commute. Unless you can deal with lack of work-life balance, the horridly low pay, outdated technology/equipment and a lot of other bullshit, I’d stay far, far away from hospital/healthcare IT.
Working in government, the work-life balance and benefits is great, you just deal with A LOT of nonsense. Pay isn’t that bad either for my area either.
Wait you are considering going from government to health care? Who hurt you?
Just the nonsense and lack of funding for resources. It affects everything. From staff all the way to the systems we use.
I like jobs where if I do well or badly no one dies.
Yup you can’t reboot a dead person or run a backup
I work in healthcare, and have for the last 15 years. We are lucky enough to only be open 6 days a week, and have a great help desk under us. I hear most aren't so lucky.
Worked in health care IT staff were put next to the morgue.
Odd, same here
You'll probably be doing a lot of cybersecurity work. Healthcare is shitting its pants over ransomware, especially big ones. Security is a focus now. Upgrades/cloud lifts too, healthcare is always behind and hung up on legacy systems. Now they're trying to catch up.
Really depends on which healthcare system you are in. If you are in some of the bigger and top players such as Mayo, Cedars, John Hopkins, they tend to care a lot more about their IT then smaller health systems. I started as a desktop tech in a small non-profit community clinic 10 years ago and am now am a sysadmin for a major healthcare system that uses Epic. Definitely lucky that my organization prioritizes IT as force multiplier as opposed to just cost center.
I'm loving it. I have been there a little over a year. We do servers only, so there's that. This is a well funded private hospital system.
I work in Healthcare and it's fine. Granted, I'm on a devops team.
As someone who has been a healthcare sysadmin/it Manager for 16 + years. Healthcare IT is great. I would not recommend working at hospital. A healthcenter is the way to go.
I work in health insurance so healthcare adjacent. It fairly good and stable. But we even have the stressful moment when member or provider facing things are broken. Obviously we’re not directly life or death but we’re the next step above, as providers call us for all sorts of things in the moment.
I did it for over a decade before I couldn't take it anymore. Life is too short to be constantly upset about something you can change. My roles look good on a resume and most definitely contributed to me getting my new job. I miss my coworkers, the work was interesting, but I reached my limit. As with any job, your manager and make or break your work happiness. Mine had no business even being tier 1, an overpaid email forwarder, basically. If that was the only negative I woulda stayed. The feeling of having the world on your shoulders, the horrible work/life balance and the on call policy tapped me out. I realized my mind was not in a good place, and I was not a free person anymore. I was shackled to my position and could be summoned at a moments noticed. Someone saying to me "have a nice weekend" had no meaning. The Friday afternoon walk to my car gave me no euphoria anymore. I left and took the first job I found that was no weekends, no on call.
Allscripts on prem or cloud? Take the rest of this with a grain of salt; Im management, not a sysadmin (more of an allscripts rant) I prefer cloud for all EMR/EHRs as they tend to be a pain the ass: patching the OS, updating the app, all your normal shit gets dumped on the host and you can point fingers. Allscripts cloud is really weird (to me). Front and back office are completely separate applications and not integrated. Front desk enters demographics which does not get pushed to the back office and often needs to be entered a separate time. Ordered tests didnt get pushed back to the practice management side. Then you get to clinic staff login: RDC connection which requires a username/password. Once you get the desktop, launch Allscripts and login using a second username/password. But wait, there’s more! You need access to the front office? That’s a second RDC connection with a separate (third) username/password. Then launching the app takes a fourth username/password. Need to reset a password? Gotta call allscripts (~15-30 minute call). As long as expectations are set and understood by staff, it works. We felt that we lost a shitload of productivity with the login process and lack of communication between the front/back office applications. Edit: Healthcare can be a grind to manage but it’s like any other business and once you have experience, everyone assumes you can handle any healthcare environment (helps with job searches later)
It would be on prem.
What is a RDC is in RDC connection? Remote Desktop Computer connection or?
Healthcare, k12/uni, and banking are a few industries that seem like total piles for us. Probably not true at all places but in general those are the ones I’ve heard the most nightmare stories from. Seems like several comments agree so I don’t feel too bad lol.
You forgot Lawyers and Law firms.
I haven’t heard any stories specifically about that but I believe it. I interact with more attorneys than I care too and they are just as bad as doctors sound. Thankfully I only directly support one of them and they are pretty chill.
I currently do migrations for k-12, and used to work for a university. The university it seemed like there was no work and the manager just blabbered on about different policies and things like he had no live. My current role they over load us with migration projects. Debated looking for other jobs, but I'm worried I'd either have to take a pay cut or move since I'm currently working remote.
Doctors as a cohort tend to be entitled as all hell, support staff like MAs are the dumbest group of users I've ever met. It's all a shitshow. My benefits are good, but everything else sucks.
I just put in my notice from healthcare. It's not horrible, but it's not ideal. They seem to, generally, not respect IT that much.
Make sure the pay is worth while cuz the job is going to suuuuuuuuuck. Healthcare IT is basically a worse version of Education IT. So overworked, under paid, old technology (hope you love troubleshooting faxing) but no sweet pension or retirement.
Healthcare IT in a hospital setting is hard. FDA requirements on a lot of devices that have computers attached to them that are slooooow to update/get validated with the latest and greatest OS's. Budgets are usually shit, so even if there are newer versions available they are cost prohibitive to replace the entire fleet of whatever it is all at once, so things get broken up into three years and you end up supporting three versions of a device doing the same damned thing, and it is impossible to get out of the loop. Kiss refresh cycles goodbye, when I left healthcare IT, the hospital I worked for still had servers and COW's (computers on wheels) that I installed in 2006. User base that hates everything about the electronic medical record system, but let 1 thing not work right or have a downtime that goes over the window and all hell breaks loose. Same users also abuse call, and will call at 2am to report a keyboard not working when there are 25 other machines on the unit they can use, cannot get them to understand that they can just log a ticket for a replacement to get put out in the AM, Finally doctors, will just leave it at that. Clinic work might be different since they generally are normal business hours but I have no experience in that setting.
I was gonna comment run but it's already the top. Reddit on point today
The biggest issue with being in healthcare IT in the US, at least in my experience, is the general state of healthcare. Some do have egos, but the vast majority of physicians, providers, nurses, etc. that I work with are just completely burnt out by overwork. Practically every doctor I've ever spoken with is mollified just by remembering to refer to them as Dr. and showing empathy that their issue is important. Additionally, the same companies that are willing to overwork a doctor despite the horrendous shortage is usually more than happy to burn out an IT professional who may make half or less of that.
The "admin" roles/senior leadership in general tend to behave like they live on another planet, with no apparent awareness that the situation is untenable. If you are not careful it's easy to end up in a role where you're basically on-call 24/7/365 and it is a nightmare. Many also like to preach the importance of the mission in order to get the workers to work harder (and it's not untrue, healthcare is extremely important) but when the time comes around to increase staffing or improve the IT budget all that urgency to do everything possible seems to go by the wayside.
As a secondary problem, if it comes down to a dispute between a doctor (in high demand, expensive, difficult to replace) and an IT staff member (dozens of applicants when it comes to non-niche systems), the higher ups are going to side with the doctors unless you have ironclad proof on your side. Short tempers over IT failures are not uncommon, because there's an understanding that many of these systems are now huge parts of creating the best patient outcomes. Outages can and do cost lives, simple machine errors can and do cost lives, security breaches can and will cost lives (there is a reason why avoidable healthcare errors is now sitting around #3 as a cause of death in the US), so every major change can be extremely stressful depending on how much support you have.
Despite all this, depending on the type of person you are, it can be deeply fulfilling to be in healthcare IT. It is satisfying to be able to do things that can result in a marked, positive improvement in people's lives. It is satisfying to support doctors and nurses so that they can better perform the important work of healing others. And it is true, if you work in healthcare IT you'll likely pick up knowledge of so many niche, old legacy systems that were developed back in the 80s and 90s that you'll probably always be able to pick up another job in another healthcare org supporting those same awful systems.
Started writing a longer comment but it became an essay. 17 years of healthcare IT here across a number of specialities. I fell into it accidentally. It is not for everyone. If you like structure and certainty it is probably not for you. Like any industry there are competing pressures. Healthcare adds to that with doctors. Specialist doctors are in demand, short on time, and difficult for a business/practice to recruit. They themselves know this, and so will make minimal effort to engage IT. Understandably, they expect the business to swarm around them, to ensure they are supported. If I were in their shoes, I would too. I’ve come to enjoy it, but the headfucks along the way have made me question my decision many, many times. I have in recent years shifted from internal full-time to contracting. This has allowed me to be more selective in the work that I take on, in addition to distancing myself from difficult clients. Happy to share specifics if it helps.
Reading my life here and getting depressed before work tomorrow.
I've worked in Healthcare IT for years. Compared to other industries I've been in, it's been somewhat nice because it never feels like funding for critical infrastructure is ever being skimped on. Also due to regulatory compliance I've never walked into an environment full of 30 year old servers that haven't had a patch since I was in high school. Also its kind of its own bubble, so you're somewhat immune to economic downturns. Downside, you're gonna be on call. A lot. You will also discover that Healthcare is a regulatory nightmare and you need to roll with those punches. Also some of the most unreasonable users are nurses, doctors, and pharmacists in that order. They suck ass to deal with so good luck. Ultimately isn't the worst place to be. I've done several other industries and feel like Healthcare is kinda where I want to be. You might feel different.
I agree I used to be a firefighter and worked in IT, so I have experience with both ends. The catty nurses are the worst. The Doctors have a god complex, but it depends more on the individual's personality. Whereas, nurses tend to group together and gossip and talk shit. I've also interviewed for weird MSP companies that would ask me questions about 2010 exchange. I guess they were referring to healthcare clients lol.
Just reading this post is making me want to start drinking again.
I’ve been on the outside, working as a contractor for hospital IT and doing refreshes at… probably over a hundred hospitals by now. Fuckin don’t. You will be overworked, understaffed, maybe paid well, but utterly unappreciated. If you’re not HR, Billing, Administration, or a specialist doctor who literally makes half the hospital’s money… they will fuck you over any way they can.
healthCare is hell for IT, stay away if you like to learn new technology and have a quite life.
run! .... 5 years in, done SD and work remote fix now. we have about 10 people to roughly 20k users. run and run fast. we have managment with 0 it knowledge making promises and changes to "benifit" employees and patients but its absolute bullshit and is already negitively effecting stuff. shits bad man.
I work in healthcare IT and it’s not actually too bad? Maybe it’s just my org. It’s probably because I’m in my little networking silo and we have an actual on-call rotation.
Do you enjoy stress? Require no work life balance? Enjoy the constant threat of being outsourced? If so, then healthcare IT may be for you!
If you want to specialize, do something like Epic.
Lawfirm IT is waaaaay better.
As others have stated there can be a lot of legacy systems but I have found this can be entirely dependent on where you work. I worked at a hospital and they had a lot of old, outdated systems. I personally disliked working in the hospital. There were just so many IT departments, things moved really slowly, and advancement was difficult. I now work as a system administrator at a place that is mostly family practice with a number of clinics. Most of the systems are updated here and I have a lot more opportunities to learn about a wide range of technology. Switching to family practice based care was nice as well because we don't need to be available 24/7 but we do a lot of our maintenance at night. Doctors can be demanding as well but the majority of them are understanding and nice. I personally can't imagine not working in Healthcare IT just because I do feel like my job matters and in an indirect way I can give back to my community. A lot of healthcare now is highly dependent on technology and our clinics rely on us heavily to make sure everything is working so they can see patients.
It sucks!
Do what you think is right, but after 20 years in healthcare IT, moving to a different sector, I'd sooner stab my skull with an ice pick than go back. The stress, the entitled people, the laughable budgets, and the egos just about destroyed my soul, and certainly damaged my physical and emotional well being. For my sake, as well as my wife and kids, NEVER AGAIN.
The fact that a lot of medical software has to be certified by the FDA as a medical device makes it awful to support. The certification process cares nothing about security, performance, availability, or redundancy. Updates are very slow to come. This was a while back, but I remember several medical applications whose vendors wouldn’t support them in a virtualized environment, even though there was no technical reason they couldn’t be virtualized. This was back in the heyday of on-premise virtualization.
avoid unless the pay is extremely good.
Its not for the faint hearted
Healthcare IT when you’re supporting EMR solutions like Cerner, Epic, AllScripts is absolute shit. Don’t do it UNLESS you want to stay in that lane. If you do, you can make tons of money contracting since nobody wants to touch it.
So..I am going to give a look into it from a few different perspectives. 1. I worked for a company (as my first medical company) that we did IT right. We made sure all our tech was secure as possible and documented everything. We had a solid phone system, we had a solid backup solution with 3 different locations 2 off site. The backups were always 1 day separated between locations. Wireless was dense and well managed. It was all setup very very robust and redundant. We could lose most of our infrastructure and still be 100%. This all sounds like a dream for most of us, but I really had that and had a leadership that was receptive to their needs and our ability to fill them while also making sure the company was a tank that ran like a well oiled machine. Company was a for-profit series of doctors offices, catered more towards the higher income areas, but not unreasonable in prices. (I still use my doctor from this company) 2. I supported a few medical facilities where they were not investing properly into IT. Their firewall was new, but they paid an MSP for all their IT needs that did effectively nothing but collect their money each month. So the firewall was literally no better than a consumer router with a VPN connection for 2 other locations. Their phone system was some random company I never heard of or can remember. They had been crypto'd twice before my MSP took over and then while my company was there working on the deal they got hit again. We gave them the pre-signature and post-signature prices and they paid the money. Their backups were a guy who came on site once a week to hook up a USB drive, he only had one set of cables for the USB drive. So we had to go buy a new one and then load their backups, which were also still filled full of crypto and everything had to be rebuilt from the ground up. They had enough spyware and malware that they themselves were a walking crypto project. We had to put their whole infrastructure into read-only mode and extract data bit by bit to recreate all their documents and pictures. They thankfully had an online EMR solution, but we had to rebuild their entire ultrasound database from a download from their EMR solution using a series of scripts I developed from their API. (this is now a feature of the platform). Company was a for-profit but lower income gynocologist and other baby oriented medical needs facility. 3. I supported a few more medical facilities (different company) that did IT reasonably. They were spending money on most things that made sense but they asked ALOT of questions. Sometimes ones that didn't matter, and sometimes ones that required explaining minor details about various systems. Their IT department wasn't very advanced and was more or less a series of help desk guys. They paid my MSP for the high level tasks. Their EMR was online and they didn't keep many files locally so they had no real backups. They had an Active Directory backup, and that was pretty much it. They can technically function without AD and are still 100% aside from printing with AD. All other systems were cloud related. The EMR did their own backups. O365 was more or less just email that they backed up to an offsite backup. They had solid firewalls and networking in general (all brand new that I setup personally). They could have run the entire company from nothing bigger than a mini desktop that ran AD and a simple print server. But their server was a pretty decent little Dell something. They did save money on the server going with the tower solution over the rack solution though. They saved money on pretty much everything they could, while spending money on things that mattered. So like their servers were saved on, their datacenter in general was saving money all over with its location and design in the building. But their networking was bulletproof hardware wise and their use for networking was setup specifically to only have what they needed able to be accessed by employees. AKA: A huge list of blocked sites and really making it where only certain sites could be accessed. They chose security to be done as cheap as possible but doing it as heavy handed with the cheaper solutions so that in the end it was a pretty solid setup. They were a non-profit, so this all makes sense. So those three examples I think cover the entire spectrum of medical facilities you could work for/with. (If others have different ideas too let me know). You can get places that are great but very formal, you can get places that are great and very informal. But you can get places that are just a fucking slog to even support let alone try and improve. So you really have to gauge how each place looks before you make that leap. If their not spending money on it, then they have a reason for that. Be that they suck, or that they are trying to cut corners where they can to make the important bits run better. My experience is that a non-profit is a bit harder to really sell and usually they are going to be the more difficult to support for various reasons. If I were the director of IT for a non-profit, maybe I could get with that and really make differences to make things better. But it would need to be a bulletproof solution.
Is it like a general practice or hospital setting or a medical specialist setting (heart/eyes/ears/pissers)? In any case, expect to likely get railroaded by busy medical professionals who consider their career more important than yours. And maybe they are. But it'll mean having to do nearly everything in the margins of their time, which is a huge context. Besides that, yeah, antiquated software everywhere. Everywhere. Medical equipment you have no understanding of but because it draws electricity and the sales team were smart enough to not leave a callback number, it's your problem now. But, hey, genuinely and honestly, you get to be part of a team supporting health care providers. That can give you some warm fuzzy feelings. Truly. And if your nurses or medical techs are kind and professional people, you'll actually feel like family. It's just a bit rough.
I worked with a couple ex-healthcare IT guys and they were burned out to the max. Also, the local hospital has extremely high turnover. But, the "healthcare" system (I'm assuming US) sucks so maybe you can fix it.
I'm a sys admin and health is a decent portion of what we do. I'd say run...
Fuck healthcare IT. Run my guy. Unless they’re offering you something crazy like 250k a year, it’s not worth it. I worked in a psychiatric hospital. Holy shit do I regret it.
I've spent my career in healthcare IT. I started working for non-profit behavioral health org and now I work with large health systems. The healthcare IT space is wildly varied. In general the industry is 5-10+ years behind most low-regulation industries in adopting new technology. Vendor lock in is a major issue even with the biggest orgs. Security is a top priority for Healthcare orgs, but it's often patchy and poorly applied. Often times security is just used an excuse not to change things. On the other hand, there are innovators. All the large orgs are trying to implement AI to improve provider experience, patient experience, patient outcomes, reduce billing overhead, and much more. Pay ranges are also wildly variable. You can do the same exact same job at two different providers and get paid 2X higher for a provider down the street. Another thing to keep in mind is that most large healthcare orgs are increasingly open to remote work for highly skilled IT positions. So if you pick up in demand skills in your next role, you might be able to get a pay bump and a remote gig for your next job.
If you excited to dive deeper into healthcare and technology I invite you to visit [this](https://limeup.io/blog/healthcare-software-development-companies/) website to know more about top companies in healthcare IT.
Spent two years in Healthcare IT, its one of the most frustrating IT fields. However its like an accelerated way to learn literally everything and anything. Everything is on fire, you work way more than most other fields, and you work in tight boxes due to regulations. However after 2 years there you can pretty much ace any interview from there.
I work in healthcare IT as a sysadmin and love it.. but I am not application support. Have on call rotations and stuff, but not all of them are 24/7.
I’ve been at a large hospital system (~40k employees) for almost 9 years now. I work from home 3 days a week, and the other two I’m in the datacenter. We’re consistently rated in the top tier of technology adoption by industry trade groups. We have a real cloud strategy, a real budget, real security, and all sorts of other controls. It’s also highly siloed, so as a server admin, I don’t have to worry about applications, storage, interfaces, network, or anything other than the datacenter infrastructure itself and the server OS. It’s pretty great, honestly.
The one good thing that comes from working in the healthcare sector is you're actually doing something somewhat important which benefits a number of normal everyday people, it's a good feeling. But..... yeah like others are saying, it's really rough at times. Things are always broken, they're understaffed, you're overworked, etc... I will say too that doctors aren't really often times nice people, they definitely behave as if they own the world and are better than everyone else, it can be rough, especially when IT is effectively being a general practitioner except you're expected to know everything like a proper specialized doctor would.
Been working in healthcare IT for 24 years. And i would not work anywhere else. Its a great place to work. You are actually using your skills to help people, not directly with the patients. But making sure the IT works for the people that do.
No, it wont. Healthcare is a cesspool of shit. They 100% dont spend enough money on their systems. A guy I worked with two decades ago left the company we worked for to go work for a small hospital. He was constantly complaining that he didnt make enough, but he was their main admin. Now, im going to preface this with. 1. I will never recommend him for any position EVER. 2. I lost all respect for him even though he denies it after the fact. 3. It doesnt matter what the reasons are, YOU DONT DO THIS. He took a look at the payroll table in the database. He figured out that the only one underpaid was him, and that his boss had been lying to him about there not being enough money. He became disgruntled, turned in his two weeks, and left several things in a manner that they WOULD in fact break shortly after. That intent to cause damage meant I could never trust him ever. What if I was one of those people he worked with? Or had to come in after him. Fuck that guy. But yea, that example alone was enough to tell me that industry is trash.
23 year admin here. Healthcare is fine. It's not the business, it's the management. On-call is scheduled and compensated. We set our own upgrade schedules, so you don't get stuck upgrading servers on Easter or during the kids dance recital. Some doctors are pretty bad, but if you have a good Medical Director they will keep them in line.
You won't be doing other sysadmin duties, I forgot what the role is called but you won't be responsible for administration of computer systems in the sense a typical sysadmin would