While not directly related to FOSS in medicine, CIO magazine has an article on what can happen if an organization fails to act on upgrading/changing critical systems (in the case of Comair, a $20 million loss and 1,100 flights delayed or canceled) as well as how such systems can become completely enmeshed in the business it serves: ‘…Unfortunately, you can’t see a crew management system age the way you can see an airplane rust. But they do. “These systems are just like physical assets,” says Mike Childress, former Delta CTO and now vice president of applications and industry frameworks for EDS. “They become brittle with age, and you have to take great care in maintaining them.” Parallels can be drawn between the airline industry and medical computing. This link courtesy of Slashdot.