Hospital SysAdmin here.

Our infrastructure is roughly 95% windows and 5% Linux or Unix. Simply put: the requirements of the software/systems that the hospital requires to function properly is what dictates the OS.

We have a couple of major systems running on a handful of AIX Unix boxes and several dozen other systems that run RHEL, Cent, and Ubuntu. Not including hypervisors, the rest of our infrastructure is windows based and ALL of our workstations are windows.

Every app is unique, and annoyingly there is no consistency within all of a single companies applications. For example, I’m working on a GE Carescape upgrade which uses CentOS 7 but GE Time and Attendance uses Windows Server.

I work IT at a hospital here in the US. The key issue is compatibility. Most of our vendor software flat-out does not support Linux at all, either on the client or server side. Shit, half of it barely even works on modern versions of Windows.

Most hospitals in the US don’t even use the OS as much as they use their EMR system (EPIC). You boot the computer, you double click on Epic and you login. No real interaction with the OS.

I would say laboratories would have the biggest problem with Linux. Laboratory information systems, third party software for different equipment as well as bridging software between these two are all on Windows.

I know Linux has little to no penetration in health equipment firmware because a lot if not most of them have hard real-time requirements that Linux just doesn’t quite reach. QNX4 is a real-time Unix flavor that has been used in fancy graphical heartbeat/multi stat monitors. Its microkernel architecture allows for a watchdog to restart individual drivers so it’s more fault tolerant.

Someone who works in hospital system posted about this in a comment earlier : https://lemmy.ml/comment/9989330

Software for equipment and software for imaging etc. I work in healthcare. I’d love to use Linux but we’re stuck on software that is based on Java from 8 years ago, as the newer version is not compatible with some older equipment. Add to that, the newer version costs $500 per user to upgrade with no additional features, and this is just for one medical camera, that treats the camera like a webcam. The problem is how it stores images is in a custom database, through a server. Otherwise, the Java part should be easy enough.

Medical equipment is super expensive and they only make a few thousand of some of them. So, the software is super expensive too and not updated nor is there versions for Mac or Linux. Heck, most of them don’t officially support windows 10 or 11. It’s really frustrating too, as most are really a simple bridge that connects to the machine to give instructions or receive data. They are not usually drivers, but send data over the network. An open format would suit better for security too, as all this old software will be pretty leaky.

I work in the NHS and I wish we’d move to Linux.

The reasons we didn’t are historically due to legacy apps that were Windows only proprietary. We used to have software in different departments of different ages - literally we had a tool that went back to the 1980s (needed telnet to run).

We recently upgraded to a single uniform EPR platform and pretty much most if not all our legacy apps got replaced. Most of what we do now is either via the EPR (which runs in a streaming VM or via a Web client), or Web apps.

So we could switch to Linux. But we probably won’t - we still have inertia - IT are familiars with running windows and all our software is configured to run on Windows or authenticate using Windows domains. It’d take effort to unpick that and fix it.

Also we use Microsoft Office throughout - while that can also be web based, that would also disincentivise the switch. Having to train every member of staff (particularly the less tech savvy staff) to use a different office system would probably put off anyone in IT considering it (although I think for hospital uses its perfectly doable). Deploying office 365 via browser is doable but effort.

So previously it was legacy apps (which will still be the issue in many places, we’re unusual to have consolidated so much to one EPR platform - even among customers of the EPR) but now it is inertia. I can see no decent reason why we could not switch entirely to Linux. It’d come down to the cost savings of dumping windows licenses / ecosystem versus the alternatives including the cost of retraining and rebuilding infrastructure.

Edit: also even if we were to replace our desktops with Linux and Web interfaces, at the backend some tools are Windows server based. And it’d be up to the software suppliers whether they actually have a Linux client for our EPR or Pacs system, even if they are supposedly using Web interfaces.

None of the hospitals I’ve worked at (in the US) have used Linux, and I’m pretty surprised some do! Given that we used Internet Explorer up until the very last second before it was not supported, I don’t know if any change would be welcomed, unless a hospital somehow started out with Linux. But at the end of the day, it would be about to e electronic health record, if it was supported or not… I don’t know if Epic, Cerner, or AllScripts do!