> What if, instead of having to reach out to the big players, the economics of having a software developer or 2 on staff make it such that you could build custom-tailored, bespoke software to work "with" your company and not against?
The behemoths exist especially, but not exclusively, in that space because regulations (correctly) are steep. In the case of hospital systems you're talking both the management and protection of both employee and patient data. That's not to say of course that the behemoth's are particularly good at that, it's merely that if the hospital rolls it's own solution, as you suggest, they then take on the liability should that system go wrong. On the other side, if Epic has a data breach, every hospital shrugs it's shoulders. It isn't their problem. And, even more fundamentally, if Epic as a product sucks ass... well. The employees didn't choose it, neither did the patients, leadership did.
You see these relationships (or lack thereof) all over the place in our modern world, where the people doing the work with these absurdly terrible tools are not given any decision-making power with regard to which tools to use. Hell, at my workplace, we actually have some in that leadership asks if we're happy with our various HR softwares and things, but fundamentally, they all pretty much suck and we're currently sitting at the least shitty one we could find, which is far from a solid fit for our smaller company. But it's the best we can do because none of these suites are designed to be good for people to use, they're designed to check a set of legal and feature checkboxes for the companies they sell to.
Honestly I don't know how you fix this, short of barring B2B SAAS as an entire industry. Time was, when you wanted to run a sales company, you had to run your own solution to keeping track of internal data. Salesforce didn't exist. You had rows upon rows of file cabinets, if there was a fire data was a lost, if a disgruntled worker stole your sales list and sold it to a competitor, that was it's own issue to deal with. Now crooks can crack the locks off of NetSuite and steal your whole fucking business without even knowing where the hell your HQ even is or caring for that matter, and our business universe if you will is bifurcated all to hell as a result. Companies are engaged in constant games of "pin the legal responsibility on someone else" because to compete, they need internet and software based sales and data management systems, but building those systems is a pain in the ass, and then you're responsible if they go wrong.