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8 Steps to Ensuring a Smooth Transition Between EHRs

Analysis  |  By Eric Wicklund  
   June 29, 2023

EHR platforms are complex and costly and require a lot of planning to make sure they're a good fit for a health system. Here are 8 recommendations for organizations looking to transition from one EHR to another.

Editor’s note: This article appears in the July-September 2023 edition of HealthLeaders magazine.

Electronic Health Records platforms have been around since the first EHR was unveiled by the Regenstrief Institute in 1972. And while there are just as many horror stories related to EHRs as successes, there's little doubt that the technology is integral to a health system's growth and development.

As with any technology, EHRs have evolved considerably since their first iteration, with new tools and capabilities that can address key healthcare pain points, both administrative and clinical, and address new capabilities like interoperability, virtual care, and even AI. The market has also grown, with new companies that can tailor EHRs to specific specialties.

With that in mind, health systems need to think carefully about their EHR investment, whether they're purchasing a new platform or transitioning from one to another. It's an expensive undertaking, not only for the initial software purchase but also in staffing, training, and workflow adjustment, as well as down time and the inevitable problems that come with a new tech installation.

Many health systems are now considering switching EHRs, either because they've outgrown the legacy platform they started with or they're not satisfied with the product.

"Such a transition requires a substantial investment in planning, preparation, and execution," says Ezio Castellani, vice president of healthcare and life sciences at IT consultancy company DataArt. "The prices of purchasing the new system, hiring additional staff, and providing training increase, and healthcare organizations’ budgets may not have room for large-scale IT projects. Furthermore, it will likely significantly impact patient care and the hospital's financial performance, so the decision needs thorough consideration and budget planning."

Key to that transition is data migration. Health system leaders need to develop a reasonable timeline for the transition, he says, with the understanding that this will be time-consuming. Aside from integrating all of a health system's technology, from software platforms to devices, into the new system, they also have to adjust workflows and train everyone on the new system.

"Rushing the switch to a new system can lead to errors and negatively impact patient care, while prolonged transition can increase costs and frustrate staff," Castellani says.

For healthcare organizations considering this move, Castellani offers eight recommendations:

  1. Develop a detailed plan before beginning. Include detailed timelines, roles, and responsibilities for everyone involved, and be sure to build in contingency plans and time considerations for the inevitable unexpected issues and delays.
  2. Consider outsourcing integration assistance. Not all health systems have the technical expertise on hand to manage a project this complex. A third-party system integrator can assist with or even handle many of the tasks associated with the transition, from project management to data migration to customizations. It's vital that this be considered early on in the process, so that time spent reviewing vendors and associated costs are included in the budget.
  3. Get everyone involved. Key stakeholders, including physicians, nurses, and IT staff, need to be part of the process from the planning stages, so that everyone understands the transition and can offer input on how it will affect their departments. There are plenty of stories about new technologies that have failed because the end-user wasn't included in the planning process.
  4. Test, then test again. Technology installations rarely go as planned. Putting the new platform through repeated tests enables everyone involved to see how the technology will work and spot potential issues or pain points. This includes testing data migration, user interfaces, functionality, and customizations.
  5. Don't skimp on training. Make sure everyone who will use the new platform gets the training needed to understand how it works, including instruction on what to do when something goes wrong. A fully prepared workforce reduces the lag time when the new platform is launched and improves the chances of a smooth transition.
  6. Ensure data integrity. Perhaps the most important aspect of the transition is ensuring that all data moves from one platform to the other, and that it can be located and used accurately and consistently in the new system. This is not only a functionality issue, but a patient safety issue as well. Have protocols in place to ensure that all data has migrated, with no gaps or errors, and have procedures in place for data backup and recovery.
  7. Keep an eye on the EHR. Once the new platform is up and running, it's essential to monitor how it's working and how it's used. Establish processes and protocols that will enable management to quickly spot and address any issues before they become much larger problems.
  8. Create a support network. Establishing a help desk and/or technical support team ensures that anyone using the EHR knows who to contact in an emergency. This will cut down on a lot of the stress and frustration associated with using the technology and ensure that problems are quickly addressed.

"Changing EHRs can be challenging and require extensive planning, preparation, and execution," Castellani points out. "Healthcare organizations must carefully consider the challenges and potential risks of transitioning to a new system before deciding to do so. Adequate planning, training, and budgeting can help mitigate potential risks and ensure a successful transition."

Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.


EHRs have evolved considerable since they were introduced to healthcare in 1972, and many new vendors have entered the market with specialized products.

Health system leaders need to plan carefully when transitioning from one platform to another, giving thought to downtime, training, data migration, monitoring, and outsourcing technical assistance.

A good transition plan takes into account the unexpected, and includes time, money, and protocols for fixing errors, smoothing over rough spots, and reducing stress and frustration.

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