I work in the healthcare industry. Basically we ARE the industry nowadays, and we use excel and word to keep everything "organized". There are some half-ass designed software,websites, and databases that are used as well, but it's amazing how a multi-billion dollar company can rely on this level of technology. I think they get these bids to run state government programs, and have absolutely no plan in place. And for some reason instead of just automating or updating things, the company just throws bodies at the problems and makes everything "production" based. I'm sure a lot of places are similar, but this is a white collar factory on such a massive scale, it literally sickens me. There are so many channels that approval for changes has to go through, that by the time some small minor change is implemented its already way too late, too distorted by having so many hands touch the problem, and too outdated.