I really don't know - I was never in that section of the business. Speculating...maybe they have their framework or some other VB6 piece certified for HIPPA compliance and don't want to change?
That industry is very old fashioned though - another good example is that every blue cross franchise uses the same software to process medicare/medicaid claims, and that software is powered by COBOL. At first it's shocking and you wonder how on earth things stay on the rails...but after a while you get used to it, a strange status quo.
I feel like it makes sense to use COBOL to talk to a government mainframe that’s likely also using COBOL, and likely has a wire protocol specced as a set of ready-to-use COBOL client structs.
Sort of like, in the modern day, it makes sense to use Go if the goal is to write an adapter that takes stuff from your database and pushes it out to some remote consumer that speaks ProtoBuf, and has a ready-to-use ProtoBuf schema.
That industry is very old fashioned though - another good example is that every blue cross franchise uses the same software to process medicare/medicaid claims, and that software is powered by COBOL. At first it's shocking and you wonder how on earth things stay on the rails...but after a while you get used to it, a strange status quo.