EHR Migration
Supporting a community health center through EHR migration while protecting clinical continuity and historical patient data.
A single-site community health center needed to transition to a new electronic health record system after organizational changes made it ineligible to continue using the EHR available through its previous healthcare-system partnership.
The transition involved more than transferring patient records. The clinic needed to preserve access to historical information, validate critical clinical workflows, coordinate connected systems and vendors, and limit disruption to patient care.
The implementation focused on three priorities:
- Preserve historical patient information and data usability
- Minimize clinical downtime
- Validate critical business and clinical requirements before relying on the new system
Requirements-Based UAT
Existing business requirements were used as the foundation for implementation validation.
Requirements, defects, and configuration issues were tracked in Jira so the implementation team could clearly distinguish between validated functionality and unresolved issues. Clinic staff could participate directly by adding comments and non-PHI screenshots using sample patient records to demonstrate problems.
Partnered UAT sign-off used the requirements as a validation checklist.
Requirements were also prioritized according to operational importance. Clinical workflows and access to patient information were treated as go-live priorities, while lower-priority configuration and testing could continue during stabilization.
Pilot Before Full Migration
Before the pilot, vendors were asked to confirm required inputs, dependencies, responsibilities, and expected turnaround times. These dependencies were incorporated into the migration timeline and used to establish clear expectations across vendors.
A pilot migration was then completed before the full production migration.
Clinic staff reviewed migrated records during the pilot, allowing data and workflow issues to be identified and corrected before the entire patient population was moved.
10% Chart Review for Data Validation
Clinic staff reviewed approximately 10% of migrated patient charts, selecting records that would provide meaningful tests of the migration.
Staff compared patient information in the legacy EHR with the corresponding records in the new system.
The review uncovered issues that would not have been identified simply by confirming that records had transferred, including:
- Patient information appearing in unexpected areas of the new chart
- Patient-status values requiring remapping to clearly distinguish deceased and inactive patients
- Historical records appearing in the wrong chronological order
- Migration logic using the wrong source date to sequence historical information
The date-mapping issue was traced to the migration logic, the appropriate source date was identified for the vendor, and several data uploads were rerun to correct the historical ordering.
Where the legacy EHR contained information without an equivalent structured field in the new system, historical information was retained as documentation rather than discarded.
This made the validation process about more than whether data moved. It assessed whether historical information remained accessible, understandable, and usable in the new clinical environment.
Systems and Vendor Coordination
Implementation required coordination across the EHR environment and supporting systems, including:
- Pharmacy integration
- Practice-management systems
- Provider registrations
- User accounts
- System configurations
- Data migration and remediation activities
Vendor issues and dependencies were tracked throughout implementation, with unresolved items documented, corrected, retested, and validated.
Clinic staff also received ongoing updates on implementation status, outstanding issues, and operational expectations.
Operational Continuity Planning
The migration was planned around both the expected cutover and a worst-case scenario.
The target downtime window was 24 hours, while operational workarounds were established to support the clinic for as long as one week if necessary.
Actual downtime was approximately 48 hours.
The legacy EHR remained accessible in read-only mode for 60 days after migration, giving clinic staff access to the original patient record while migration quality and workflows continued to be validated.
The community health center successfully transitioned to its new EHR with critical clinical workflows and data-access requirements validated for go-live.
of patient charts reviewed for migration quality
of actual downtime, within a one-week contingency plan
of read-only legacy EHR access during stabilization
Requirements-based UAT
used to validate critical functionality and track unresolved issues
The implementation identified and corrected multiple migration issues, including patient-status mapping, record placement, and chronological ordering.
Historical patient information was retained even when differences between the old and new EHR data structures prevented a direct field-to-field migration.
UAT, configuration work, and vendor remediation continued after go-live, allowing the clinic to begin operating in the new environment while lower-priority issues were addressed during stabilization.
A successful EHR migration requires more than moving records from one system to another.
The DOMAS Group combined requirements validation, pilot testing, staff-led chart review, centralized issue tracking, vendor coordination, systems integration, and contingency planning to create multiple checkpoints for identifying migration problems before they became larger operational issues.
The result was a transition centered on what mattered most: keeping the clinic operational while protecting access to the patient information staff needed to provide care.