>the reality is that the majority of established businesses are using unsexy and what they would consider to be "legacy" technology.
I once asked a question online about a legacy technology. The only answer I got was a smug "don't use [technology], it's outdated."
I work in a "people's lives depend on this" industry, not a "move quick and break things" industry. That's why I am working with "outdated" technology.
We could have spent hundred of millions of dollar and several years to rewrite the system I was working on to use the latest technology stack. But for what? It works and does its job well.
I would argue that it isn't about how old the technology is but how good the developer tools and support are. Newer technologies (not brand new, ones that have a few years of maturity) often have better support in common developer platforms, more tutorials and answers on StackOverflow, etc. They are also easier to find employees to hire who know how to use them (or who WANT to use them).
If an older technology is so great then my preference would be to build modern tools for that old technology and then it would be like new. If you can evangelize this old-made-new platform a bit then you could find more people willing to use and learn it, which would fix the online presence and employee hiring problems too.
Note that MUMPS is one of those old technologies used in healthcare. It is basically a NoSQL database from before NoSQL was popular. Intersystems' website suggests that they've made a bunch of additions to it, but Intersystems charges a lot of money. GT.M is the open source one but as far as I know it sticks more to the ANSI M standard. That standard language is pretty old so it can get confusing to read/write it. I'm not sure if GT.M provides dev tools either. Intersystems does, but AFAIK they are not as good as tools like Visual Studio, XCode, or other newer platforms.
The way I see MUMPS or M (because clinicians don't like hearing that word) is a string typed almost-assembly level server scripting language.
GTM does stick to the ANSI M standard with a few extensions for basic escape holes like calling a UNIX process or writing to a file. It doesn't have the same level of optimization, reliability, recoverability, etc. that intersystems sells.
Does it though? Does it do its job well? Does it have scheduled maintenance every evening for the mainframe batch job? Does it not handle non-ascii in names? Does it not have the perspective of knowing how much better it could be done, like webmail before gmail?
Just rewriting in new technology won't necessarily make it any better though, I'll definitely grant you that. I'm one of the crabby people who prefers technology from the early 2000s that grew out of unix technology of the 80s. But the really really old stuff can actually have meaningful limitations.
With regards to the medical industry, most of the software and systems are truly bad (in addition to being made with very very old tech). The reason IMHO is that due to all the regulation and all the money, all the power is on the political side rather than the technical side of the market, and it's a market where users don't choose what they use, administrators choose for them (and then don't have to use it).
Does it have scheduled maintenance every evening for the mainframe batch job?
No, its used 24/7 and does not run on a mainframe.
Does it not handle non-ascii in names?
Who the hell cares? It doesn't have to.
Does it not have the perspective of knowing how much better it could be done, like webmail before gmail?
I don't even know what you mean. I think webmail before Gmail was great. Gmail is always changing its UI and confusing users. Gmail didn't bring anything to webmail except a ton of free storage.
The software is fine it doesn't have many big flaws and it operates in a space where people depend on it working right so they don't die. We still release new versions once in a while but its not too much work.
I once asked a question online about a legacy technology. The only answer I got was a smug "don't use [technology], it's outdated."
I work in a "people's lives depend on this" industry, not a "move quick and break things" industry. That's why I am working with "outdated" technology.
We could have spent hundred of millions of dollar and several years to rewrite the system I was working on to use the latest technology stack. But for what? It works and does its job well.