When we speak with hospital and health system leaders about upcoming EHR migrations, two key concerns often rise to the top during those conversations: compliance and risk. This is completely understandable. The combination of high-stakes factors involved in these projects — sensitive patient data, strict regulatory requirements, clinical operations, and more — would keep most CIOs up at night.
The good news is that most of the compliance and risk challenges that could arise during EHR migrations are predictable, and with the right preparation and the right partner, they can be planned for and avoided altogether. Here are four of the key compliance and risk recommendations we share with our customers at the outset of EHR migration projects:
- Establish a data governance team and align retention policies before you start
Before any migration work begins, confirm that your organization’s internal data retention policies align with state and federal regulatory requirements. A strong data governance team, with representation from IT, HIM, legal, compliance, and clinical, should be created to conduct this review and resolve any discrepancies. This team should also be tasked with determining what data should be migrated to your new EHR, what should be archived, and what should be purged. This will help ensure that every downstream decision is made on solid compliance footing.
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- Build security into every stage of the EHR migration
The EHR migration process involves data moving between systems, new access permissions, and increased vendor activity — all of which make it critical to ensure security protocols are airtight. Migrations require careful attention to data encryption, access controls, and audit trails to remain compliant with HIPAA and other regulatory requirements. A HITRUST-certified migration partner is essential, and helps ensure comprehensive controls that protect data throughout its lifecycle, from intake through archival and beyond. At a minimum, look for partners that encrypt data both at rest and in transit, enforce role-based access controls, and provide 24/7 monitoring and threat detection.
- Don’t treat archiving as an afterthought
As Scott Smiser, a healthcare IT consultant has noted, “When any hospital makes the decision to move forward with a new EHR, the discussion around what data will be converted versus what needs to be archived must be at the forefront of decision-making.” Organizations that delay archiving planning risk missing critical milestones, extending legacy system maintenance costs, and creating gaps in long-term data accessibility and compliance. We recommend that organizations start talking with their migration partner about archiving during their initial partnership conversations. Better yet? Partner with a vendor that specializes in both migration and archiving. This helps ensure that during your EHR migration, you’re making all the critical archiving decisions, with the best guidance, at the optimal time.
- Ensure your migration partner understands your compliance environment
More than one-third of all data breaches in healthcare are due to third-party compromises. This further underscores why selecting the right migration and archiving partner is so critical. When evaluating vendors, ask how they handle HIPAA requirements, what their audit trail documentation looks like, and how they approach data retention decisions. Be wary of vendors that rely on checkbox compliance rather than substantive, independently audited security program. We operate within a HITRUST-certified environment, with end-to-end encryption, role-based access controls, and comprehensive audit logging — ensuring data is protected at every stage of your migration and archiving process.
Compliance and Risk at a Glance
The table below summarizes the top risk areas health IT leaders should address during an EHR migration, along with the compliance considerations and mitigation strategies for each. Use it as a quick reference alongside your broader migration planning.
| Risk Area | Compliance and Risk Consideration | Mitigation Strategy |
|---|---|---|
| Data governance & retention | Internal policies may not align with state/federal requirements | Establish a governance team from HIM, legal compliance, clinical and IT at project outset |
| Security throughout the migration | Expanded access and vendor activity increase exposure | Require encryption, role-based access controls, 24/7 monitoring, and HITRUST certification |
| Archiving & decommissioning | Legacy systems carry ongoing compliance and security risks | Develop an archiving plan at the outset and decommission legacy systems promptly |
| Data purging | Improper disposal can create liability | Follow established protocols and document decisions |
| Partner selection | Third parties account for more than one-third of healthcare breaches | Vet partners for substantive security programs, not just for checkbox compliance |
Managing compliance and risk during an EHR migration requires sustained attention from planning through go-live and beyond. Organizations that approach these considerations proactively, with the right team and the right partner, are far better positioned to complete their migrations on time, within budget, and without exposure.
Harmony Healthcare IT has supported hundreds of healthcare organizations through EHR migrations and legacy data archiving projects, bringing deep expertise in compliance, data governance, and risk management. Contact us to schedule a consultation and learn how we can support your organization’s migration.
FAQs
What are the biggest compliance risks during an EHR migration?
Significant compliance risks during an EHR migration include gaps between internal data retention policies and state and federal requirements, inadequate security controls during data transfer, and poor governance around what data is migrated versus archived versus purged.
How do I ensure HIPAA compliance during an EHR migration?
Maintaining HIPAA compliance during a migration requires careful attention to data encryption, access controls, and audit trails throughout the entire transfer process. Working with a migration partner that operates within a HITRUST-certified environment provides an additional layer of assurance that data is protected according to a comprehensive, independently audited set of security controls.
What is a data governance team and why is it important for EHR migrations?
A data governance team is a cross-functional group, typically including representatives from HIM, legal, compliance, risk management, IT, and clinical leadership, responsible for establishing the policies and principles that guide data decisions. For EHR migrations specifically, this team plays a critical role in determining what data should be migrated, archived, or purged, and ensuring those decisions align with regulatory requirements.
What should compliance planning begin for an EHR migration?
Compliance planning should begin at the start of a migration project, ideally before or alongside EHR contract signing. Engaging a migration partner early ensures that compliance requirements are built into the project plan from day one rather than retrofitted later, and gives the data governance team adequate time to align retention policies, assess security requirements, and establish an archiving strategy before any data moves.
