How Large Hospitals and Health Systems Successfully Completed Archiving Initiatives

Executive Summary

• Establish scalable, repeatable, enterprise‑level archiving strategies
• Support clinicians, HIM, and compliance teams with efficient legacy data access
• Consolidate fragmented legacy environments without disrupting care delivery
• Strengthen security, auditability, and overall compliance posture across retained data
• Create a sustainable foundation for future EHR, ERP, and other enterprise system upgrades

Archived Massive Data Volumes at Scale to Support an Enterprise-Wide Epic Transition

• As part of a large-scale transition from Cerner to Epic, the organization faced an
   extraordinary volume of legacy data, including 32 terabytes of records, 75 terabytes of images, and 34 million scanned documents.
• The scale and complexity of the data, combined with enterprise-wide access
   requirements and zero tolerance for downtime, demanded a comprehensive and
   highly scalable archiving approach.
• The organization partnered with Harmony Healthcare IT to implement an archiving
   strategy capable of supporting thousands of users, meeting retention requirements, and providing a stable foundation beyond the EHR migration.

• Deployed one of the largest healthcare data archives in the U.S., supporting tens of
   terabytes of legacy records, images, and documents.
• Enabled enterprise-wide access to historical data for thousands of users, with
   intuitive usability and strong adoption across clinical and operational teams.
• Implemented the archive on time and on budget, delivering significant ROI through
   system retirement, improved operational efficiency, and reduced legacy risk.
  
  

“Our archive is an enterprise-wide win that exceeded our expectations. It takes only minutes to learn how to use it and it will provide accessible and secure data storage forever. Best yet, there is significant ROI.”

Aligned Migration and Archiving Strategies to Support a Large-Scale Epic Conversion

• As part of a large-scale conversion to Epic from Cerner and eClinicalWorks, the organization needed both a migration partner to move data into Epic and an archiving partner to securely consolidate and retain legacy data.
• Given the size and complexity of the project—including the need to provide secure archive access to thousands of clinicians—the organization required a highly experienced partner capable of supporting both migration and long-term data access.
• The organization selected Harmony Healthcare IT to support both migration and archiving needs.

• Successful Epic migration, including 6TB of data migrated on time and on budget.
• Migration of critical historical data into an active archive, with key capabilities such as A/R wind-down support and Single Sign-On.
• Established a scalable, repeatable archive framework to support future EHR, ERP, and ancillary system retirements.

“As part of our EMR transition, the data conversion and archive were critical components to our success. Harmony Healthcare IT managed multiple projects, sometimes with changing requirements, and delivered the results we needed on time.”

Archived an Archive to Eliminate Legacy Risk and Accelerate ROI

• Following the acquisition of five hospitals and a systemwide Epic conversion, the organization was managing more than 300 legacy data silos across multiple platforms, including Cerner, Allscripts, GE Centricity, and Kronos.
• At the same time, the organization’s previously selected archiving vendor was failing to meet critical deadlines. A major Cerner Millennium archive project was at risk, exposing the organization to $1.4M in recurring monthly fees if legacy data was not migrated on time.
• The organization engaged Harmony Healthcare IT to take over the Cerner archiving effort and archive the previous vendor’s archive into a single, long‑term solution.

• Successfully completed a large‑scale Cerner Millennium archive within a short, fixed deadline, avoiding ongoing legacy system fees.
• Delivered a significant return on investment in the mid six figures over five years, excluding additional savings related to infrastructure, staffing, and maintenance.
• Established a single, centralized repository for legacy data by archiving the previous vendor’s archive, creating a scalable foundation for future system retirements.

With the Harmony Healthcare IT archive, the organization benefits from comprehensive A/R wind‑down support, with billing interfaces maintained for re‑billing, collections, reporting, and compliance, and long‑term access to financial records preserved.

Responded to Urgent M&A Data Needs with a Centralized Archiving Strategy

• When the organization adopted Epic as its go‑forward EHR, it needed to retire and archive its legacy MEDITECH environment.
• Ongoing M&A activity also introduced new data types and systems, including large volumes of historical gGastro EHR imaging data that were at risk of losing read‑only access under tight timelines.
• The organization partnered with Harmony Healthcare IT to establish a centralized, long‑term archiving strategy that could adapt to evolving data retention needs while supporting secure access and regulatory compliance.

• Established a centralized, scalable archiving strategy to support legacy system retirement following Epic adoption and continued M&A activity.
• Enabled rapid response to emergent archiving needs, completing a gGastro EHR imaging archive ahead of schedule within two weeks and preserving access to historical patient data.
• Strengthened data retention and governance through a long‑term partnership that reduced costs, improved security, and supported compliant access to archived records.

M&A activity can introduce urgent and unexpected archiving needs. A centralized archiving strategy and an experienced partner can help preserve access to legacy data and avoid disruption under tight timelines.

Modernized Legacy Archiving to Meet 21st Century Cures Act Requirements and Enhance Efficiency

• The organization was operating with multiple regions functioning independently and relying on a homegrown, on‑premise archive.  
• While the archive had supported past needs, it was labor‑intensive, costly to maintain, and lacked the functionality required to support future compliance, interoperability, and patient access expectations. 
• The organization partnered with Harmony Healthcare IT for a modern, cloud‑based archiving strategy that could archive the current archive while also establishing a standardized approach for application rationalization. 

• Implemented a cloud‑based archive capable of archiving the existing homegrown archive and approximately 85 legacy applications, establishing a scalable foundation for lifecycle data management. 
• Enabled compliance with 21st Century Cures Act requirements through improved archive functionality, standardized application rationalization, and secure record delivery integration with Epic and MyChart. 
• Created a more sustainable, future‑ready data strategy by reducing internal maintenance burden and aligning archived data with broader analytics and reporting initiatives. 

“We benefit from Harmony Healthcare IT’s mature guidance. With this guidance, we have become more disciplined and sharpened our focus to standardize our data management efforts. We are seeing outstanding results.”

• After decades of growth through mergers and acquisitions, the organization was managing more than 100 legacy EHR and ancillary systems, including Cerner Millennium, MEDITECH, NextGen, Cerner Envision, OBIX fetal monitoring, and blood bank systems. 
• To improve efficiency and maximize return on investment, the organization sought to consolidate clinical, financial, and business records into a single, comprehensive archive while maintaining secure and compliant access to historical data. 
• The organization selected Harmony Healthcare IT to support a long-term archiving strategy focused on efficiency, compliance, and cost reduction.  

• Simplified clinician and HIM workflows, with secure access to historical records via Epic Single Sign‑On and more efficient, accurate release of information processes. 
• Improved security posture by retiring legacy systems and applications, reducing audit risk and limiting unauthorized access through centralized controls. 
• Achieved measurable cost savings by eliminating ongoing legacy system maintenance and upgrade expenses. 
• Established a future‑ready foundation to support evolving interoperability requirements and patient record access under the 21st Century Cures Act. 

“As part of our EMR transition, the data conversion and archive were critical components to our success. Harmony Healthcare IT managed multiple projects, sometimes with changing requirements, and delivered the results we needed on time.”  

• After acquiring four hospitals and 83 physician practices, the organization was incurring significant ongoing costs from redundant legacy systems maintained solely for historical access. 
• With large volumes of legacy data spread across multiple vendor platforms, maintaining the status quo was not a sustainable long‑term strategy.  
• The organization engaged Harmony Healthcare IT to implement an active archiving strategy that would reduce costs, improve access to historical data, and support long‑term data governance. 

• Achieved more than $2M in cost savings to date by migrating legacy data into an active archive and reducing vendor management and IT support expenses. 
• Preserved continuity of care during rapid growth by consolidating legacy data into a single archive with Epic Single Sign‑On, enabling efficient access to historical patient records. 
• Consolidated and secured legacy data across 55+ acute and ambulatory sources, including more than 450,000 documents and 182TB of data. 

To ensure record integrity, the organization validated data migrated from multiple legacy systems using Harmony’s built‑in customer validation tools. This streamlined a typically time‑intensive process.

• As part of a system‑wide EHR transition from Cerner to Epic, Main Line Health needed a clear strategy for managing legacy clinical, financial, and business records. 
• For a full year following the Epic migration, Cerner and Epic were used in tandem, increasing operational complexity and driving additional costs. 
• Main Line Health partnered with Harmony Healthcare IT to address its archiving needs, including support for accounts receivable wind‑down. 

• Successfully rationalized and archived more than 50 legacy applications following the Cerner‑to‑Epic transition, enabling system decommissioning and streamlining the IT portfolio. 
• Preserved access to complete historical legal medical records through integration with Epic, supporting clinical, financial, and compliance workflows. 
• Strengthened security and long‑term data governance by implementing an active archive with role‑based access controls, archived audit trails, and support for A/R wind‑down activities. 

If your organization is pursuing M&A activity, engage an archiving partner as early as possible. Early guidance on time‑sensitive activities can help prevent unexpected delays during integration.

Archived an Archive to Eliminate Legacy Risk and Accelerate ROI

• Following the acquisition of five hospitals and a systemwide Epic conversion, the organization was managing more than 300 legacy data silos across multiple platforms, including Cerner, Allscripts, GE Centricity, and Kronos. 
• At the same time, the organization’s previously selected archiving vendor was failing to meet critical deadlines. A major Cerner Millennium archive project was at risk, exposing the organization to $1.4M in recurring monthly fees if legacy data was not migrated on time. 
• The organization engaged Harmony Healthcare IT to take over the Cerner archiving effort and archive the previous vendor’s archive into a single, long‑term solution.  

• Successfully completed a large‑scale Cerner Millennium archive within a short, fixed deadline, avoiding ongoing legacy system fees. 
• Delivered a significant return on investment in the mid six figures over five years, excluding additional savings related to infrastructure, staffing, and maintenance. 
• Established a single, centralized repository for legacy data by archiving the previous vendor’s archive, creating a scalable foundation for future system retirements. 

“It’s been a true partnership working with Harmony Healthcare IT. Everything is 100% transparent. The energy, effort, and support from everyone involved is outstanding.”

• Recognition that legacy data archiving must evolve beyond basic retention to support enterprise‑wide clinical, operational, and compliance needs. 
• Early alignment with experienced partners capable of extracting, validating, and migrating complex legacy data volumes without disrupting care delivery. 
• Deep integration with go‑forward EHR platforms, including Single Sign-On with SMART on FHIR, Legacy Record Indicator, and MPI Management.  
• Efficiency-enhancing capabilities, such as Keyword Search and Secure Record Delivery, and automated processes that reduce manual effort for HIM, compliance, and revenue cycle teams. 
• Archiving strategies designed for repeatability and scale, supporting ongoing M&A activity, system modernization, and future technology initiatives. 

Introduction

Legacy System Decommissioning: A Growing Priority

• 80% of healthcare IT leaders say their budget for data management initiatives has increased over the past three years.
• 71% say legacy system consolidation/data archiving is among their top 3 data management priorities.

Source: November 2025 Survey of CHIME members.

• Licensing costs
• Infrastructure costs, including servers and storage
• IT labor costs, including ongoing maintenance and security monitoring

We often find that hospitals and health systems have been paying maintenance on legacy ERPs for years without realizing the cost savings that can be achieved by archival. When we explore the total cost of keeping their old system running, that’s often the moment when decommissioning becomes a priority with a very quick return on investment.

• Data volume analysis — How many years of data are involved? How many tables and records?
• Data type inventory — What discrete and non-discrete data exists? What types? HR records, payroll history, benefits, credentialing, workforce management, materials management, supply chain, others?  
• Data strategy — Which data needs to be migrated to a new ERP (if applicable), which should be archived, and which should be purged?  
• Customization review — What custom fields, workflows, or modules need to be considered?
• Access method determination — How will data be accessed and extracted for migration or archival?

• Establishing search indexes across key fields
• Configuring role-based access controls
• Migrating data to a new ERP and validating data within it (if applicable)
• Moving data to the archive and validating the data is represented correctly and completely
• Testing search and retrieval functionality

Four Key Benefits of ERP Archiving:

• Cut Costs — Eliminate licensing, maintenance, and infrastructure costs.
• Bolster Security — Retire outdated, unsupported applications.
• Increase Efficiency — Give authorized users instant access to historical data.
• Maintain Compliance — Meet audit and regulatory requirements.

Capability

What to Look For

Capability

Long-term, secure data preservation

What to Look For

• End-to-end encryption during data transfer and at rest
• Secure, controlled, audit-ready storage
• Version control and data integrity verification

Capability

User-friendly access & search

What to Look For

• Intuitive, browser-based access
• Categorization by topic and data type (HR records, financial transactions, supply chain data, etc.)
• Robust search capabilities across multiple data points (employee name, ID number, date of birth, Social Security number, vendor name, transaction date, and more)
• Sorting and filtering options to quickly narrow down results
• SSO integration so users can access the archived application alongside active systems (when supported)

Capability

Compliance & audit readiness

What to Look For

• HITRUST certification and HIPAA compliance
• Role-based access and features
• Comprehensive audit logging that tracks who accessed which records and when
• Compliance with record retention requirements mandated by the IRS, Fair Labor Standards act (FLSA), U.S. Equal Opportunity Commission (EEOC), and various state-level agencies

Capability

Experience & track record

What to Look For

• More than 15 years experience specializing in healthcare data management
• Chosen by top healthcare organizations for migration and archiving
• Strong references from similar organizations with the same ERP
• Proficiency across hundreds of software platforms, including ERP, EHR, and revenue cycle systems
• Ability to handle financial, business, administrative, and clinical information

Looking for more guidance? Read “How to Select the Right ERP Archiving Partner: 16 Questions to Ask.”

• Start early. The best time to engage with archiving specialists is when you begin considering an ERP transition or replacement, not when you see that a legacy system contract is coming up for renewal. Early engagement allows for proper discovery, planning, and execution without rushed timelines.
• Think beyond a single system. If you’re archiving one legacy ERP, consider whether other systems (clinical, financial, and/or administrative) should also be retired and consolidated into the same archive platform. Economies of scale make multi-system projects more cost-effective. A strong archiving partner can help support these decisions.
• Involve stakeholders early and often. The departments that rely on historical ERP data — including HR, finance, supply chain, and compliance — should have input on archive requirements, search capabilities, and access controls throughout the project.
• Plan for the unexpected. Discovery almost always reveals data complexities or customizations that weren’t initially apparent. Partnering with a strong and highly experienced archiving vendor can help ensure unexpected findings have a minimal impact on your project and timeline.
• Prioritize user experience. An archive that’s difficult to use will generate ongoing support burden and user frustration. Seek out an archiving platform that has an intuitive interface and Single Sign-On (SSO) capabilities.

We see a lot of organizations start with one ERP system and then realize they’ve got three, four or more other legacy applications that can be archived. With an effective archive platform in place, the process of decommissioning these systems becomes very streamlined.

FAQs

Why should hospitals prioritize legacy ERP archiving and system decommissioning?

Legacy ERPs consume significant budgets through licensing, maintenance, infrastructure, and IT labor — with costs sometimes reaching hundreds of thousands of dollars annually for large health systems. Legacy ERPs also pose cybersecurity and compliance risks due to outdated technology and unsupported software. Decommissioning legacy ERPs reduces cost, eliminates security vulnerabilities, and preserves compliant access to historical data.

What data from a legacy hospital ERP typically needs to be archived?

Common datasets include HR and payroll history, benefits information, workforce management records, financial transactions, supply chain and materials management data, and credentialing information.

How long does a hospital ERP archiving and decommissioning project usually take?

Timelines vary by system age, size, customization, and data complexity. Contact Harmony Healthcare IT to discuss your specific needs.

How do hospitals access data after a legacy ERP is shut down?

Users access historical data through a secure, browser-based archive platform with role-based permissions, search capabilities, and audit logging.

What security standards should an ERP archiving partner meet?

Healthcare organizations should look for partners that support HITRUST certification, HIPAA compliance, end-to-end encryption, role-based access, and comprehensive audit logging at a minimum.

How does ERP archiving support compliance and audit readiness?

A properly structured archive ensures long-term access to historical records and supports retention requirements from regulatory bodies. Audit trails document who accessed which data, ensuring organizations remain compliant even after the system is retired.

Can multiple legacy systems be consolidated into one archive platform?

Yes. Many hospitals that start with one ERP soon recognize the benefits of consolidating other clinical, financial, or administrative systems into the same archive platform. Multi-system consolidation reduces cost, simplifies data access, and standardizes audit reporting.

What should hospitals look for when selecting a legacy ERP archiving partner?

Key considerations include healthcare-specific expertise, experience across hundreds of platforms, validated methodologies, and strong client references.

Executive Summary

• Recover stalled or failed archiving initiatives
• Consolidate and modernize legacy access without disruption
• Improve clinician and HIM usability
• Strengthen security, compliance, and auditability
• Accelerate time to ROI while reducing ongoing system costs

Parkview Health: Switched Archiving Vendors to Get a Legacy Data Program Back on Track

• An initial archiving vendor failed to deliver on timelines, usability, and scope, leaving the organization dissatisfied with the process and outcome. 
• Rising legacy costs and long-term data-retention risk increased pressure to stabilize access.
• The organization restarted its archive strategy by partnering with Harmony Healthcare IT to execute immediately and scale over time. 

• Consolidation of 50+ legacy systems into a single archive.
• ROI achieved within 18 months. 
• Established a foundation to archive additional systems.

AltaMed: Switched Archiving Vendors Mid-Project to Preserve Record Access

• During a NextGen-to-Epic migration, the incumbent archiving vendor encountered implementation failures, including data accuracy issues and an inability to support specialized clinical imagery.
• As the legacy EHR support agreement neared expiration, the organization risked losing access to historical records.
• Leadership halted the project and transitioned to Harmony Healthcare IT. 

• Successfully decommissioned the legacy EHR without interruption to clinical or HIM access.
• Enabled fast, in–context access to historical records through Epic Single Sign–On and intuitive workflows.
• Strengthened cybersecurity posture by consolidating legacy data into a HITRUST environment. 

Franciscan Health: Switched from a Homegrown Archive to Modernize Compliance and Integration

• Internally built archive that supported dozens of legacy applications became expensive to maintain, difficult to scale, and misaligned with evolving regulatory requirements. 
• Regional inconsistency and limited integration capabilities further complicated governance, privacy, and compliance needs.
• The organization turned to Harmony Healthcare IT for a modern solution that could archive and supporting future application rationalization.  

• Migrated 85+ previously archived systems into a cloud-based active archive.
• Enabled Epic and patient–portal integration for historical data access.
• Achieved ROI with expanded functionality unavailable in the prior solution.

Large IDN in the Northeast: Switched Archiving Vendors to Hit a Hard Deadline and Avoid Escalating Costs

• Acquisition of five hospitals and a transition to Epic created 300+ legacy data silos across clinical, financial, and administrative systems.
• A hard deadline to migrate a large Cerner Millennium environment introduced $1.4 million in monthly fee risk if data was not archived on time.
• The incumbent archiving vendor failed to meet delivery expectations, prompting the health system to pivot to Harmony Healthcare IT. 

• Met a non-negotiable deadline to archive Cerner Millennium, avoiding $1.4 million in monthly fees.
• Achieved a mid six–figure ROI while consolidating multiple legacy systems into a single archive.
• Enabled seamless Epic Single Sign–On access and supported accounts receivable wind-down within a centralized, secure platform.

Common Success Characteristics

Across all four examples, health systems shared several defining traits that enabled successful vendor transitions:

• Willingness to change course when an archive solution no longer met enterprise needs.
• Experienced partners capable of extracting, validating, and migrating legacy data under time pressure.
• Deep EHR integration capabilities, including Single Sign-On and patient context sharing.
• Security and compliance treated as foundational requirements, not an add-on.
• Clear financial outcomes achieved through aggressive legacy system retirement.

Execution models designed for repeatable processes, not one-time migrations.

Next Steps

Looking for more resources to support your EHR migration project? Check out our Five EHR Migration Best Practices.

Misstep #1: The Late Engagement Trap

• Avoid setting yourself up for unrealistic deadlines or resource crunches
• Identify internal and external staffing needs before they become bottlenecks
• Complete time-sensitive activities before they cause project delays  
• Ensure data availability and any source vendor data requirements or nuances

Starting your EHR project without migration expertise is like diagnosing a patient without reviewing their medical history. You’re going to miss essential information required for an optimal outcome.

Misstep #2: The Cross-Department Blind Spot

• Incorporate each department’s unique challenges, requirements, and specifications into your migration plan 
• Understand which staff members will be needed when, preventing last-minute scrambling
• Ensure department owners feel heard, involved, and engaged

The most successful migrations are achieved when stakeholders actively contribute to designing the plan, rather than simply executing it.

Misstep #3: The Data Governance Team Disconnect

• Get faster responses to unexpected data anomalies that emerge during analysis
• Make more informed decisions regarding aligning data needs and workflows across care settings 
• Ensure all data-related processes meet your organization’s internal standards

Data governance isn’t just about policies — it’s about having the right people ready to make critical decisions quickly. Without a highly engaged team, every data question can become a project delay.

Misstep #4: The Archive Afterthought

• Streamline workflows by aligning data analysis, decisions, and planning across both initiatives 
• Ensure regulatory compliance while maintaining efficient access to historical records
• Enhance user confidence through clear communication about data availability and archive access 

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.

Misstep #5: The Scope Evaluation Trap

• Find a partner that provides realistic project timelines and costs  
• Benefit from comprehensive approach that meets your unique needs   
• Avoid hidden fees and timeline delays  

Look under the hood when evaluating partners. Some overpromise on capabilities and timelines, while others present quotes with hidden fees that surprise you later. It’s a good sign when a potential partner is asking you lots of questions during initial meetings — that means they’re considering all factors to give you a comprehensive project estimate.

Misstep #6: The Internal Resource Surprise

• Ensure milestones are completed on schedule 
• Enable department leaders to plan more proactively around migration needs 
• Foster more project buy-in among department leaders and their teams  

When you give department leaders weeks or months of notice about their or their team members’ involvement, they can plan accordingly. When you give them days, they have to scramble.

Misstep #7: The Skills Shortage Gamble

• Avoid delays caused by learning curves or resource bottlenecks  
• Access specialized expertise that may not exist internally, 
• Allow internal teams to concentrate more on their core responsibilities

There has definitely been a shift to single sourcing migration and data archive partners vs. using internal or labor augmentation for migration separate to archive. This makes complete sense as there is definitely efficiency gained in selecting a single partner who becomes knowledgeable about the systems and data to be migrated and ultimately decommissioned post archival.

Misstep #8: The External Hosting Slowdown

• Eliminate data transfer delays between external systems 
• Work directly within your network environment for optimal compatibility and performance 
• Maintain greater control over your data throughout the conversion process

Every data transfer introduces incremental time, which accumulates significantly in later migration rounds as data volumes grow or files require adjustments. Streamlining the process by removing extra steps is essential for maintaining speed and efficiency.

Misstep #9: The Blindsided Leadership Problem

• Ensure temporary setbacks are seen as normal parts of the process 
• Keep leadership calm and informed during more challenging phases 
• Approach challenges constructively rather than reactively 

Small-scale or initial testing almost always presents technical opportunities during migration projects to learn and adapt from. When stakeholders know this upfront, they see problems as expected challenges rather than failures.

Ready to Avoid These Migration Missteps?

FAQs

How early should we engage a migration partner in our EHR project?

Ideally, you should consult with a migration partner during your EHR vendor selection process, not after. This allows them to help shape realistic timelines and identify potential challenges before contracts are signed.

What's the biggest difference between archiving and migrating data?

Migration moves data into your new EHR system where it’s actively accessible, while archiving stores data in a separate system for compliance and reference purposes. Archiving is typically faster and less complex than full conversion and migration.

How do we know if a migration vendor is making unrealistic promises?

Be suspicious of vendors whose timelines are significantly shorter than others or who claim they can complete everything by go-live. Ask specific questions about unstructured document handling and comprehensive backup procedures.

Which departments should be involved in migration planning beyond IT?

Include clinical leadership, Health Information Management (HIM), legal, compliance, finance, and any departments that heavily rely on specific data workflows. Each brings unique requirements that impact project success.

Should we host the migration environment internally or externally?

Internal hosting typically provides better performance and faster data transfers, reducing overall project timelines. However, it requires adequate infrastructure and technical resources to set up properly.

What's the most challenging phase of a typical migration project?

Small-scale testing consistently presents technical hurdles because it’s the first-time converted data is tested in real-world scenarios. Preparing stakeholders for this challenging phase prevents unnecessary concern.

How much external expertise do we typically need for a migration project?

This varies by organization size and internal capabilities, but most projects require specialized skills in data mapping, conversion programming, and testing that don’t typically exist internally. Your migration partner can help assess your specific needs.

What happens if we don't involve our data governance team early enough?

Late engagement typically results in slower decision-making, potential rework to meet compliance standards, and frustrated team members who feel excluded from important decisions. Early involvement prevents these issues and accelerates project timelines.

Introduction

Key Findings

Migration Activity

62% of all respondents cite EHR implementations, conversions, and migrations as one of their top 3 data management priorities in 2026.

Nearly 40% of hospital IT leaders are planning an EHR migration project in 2026. Another 24% are planning one in 2027.

Confidence Gaps

Only 57% are confident they can complete projects on budget.

Only 48% are confident they can complete projects without major problems.

Top 3 Project Concerns

#1. Cost
#2. Staff resources
#3. Data integrity/loss

Methodology

Migration Activity and Drivers

• In the first six months of 2026: 19%
• In the final six months of 2026: 19% 
• In 2027: 24%
• In 2028: 10%
• After 2028: 29%

• Merger and/or acquisition: 38%  
• New EHR implementation: 33% 
• Other: 29%  

Peer Insights

When asked to share their top migration project advice with peers, many survey respondents offered feedback that underscores the importance of thorough and early planning. One counseled: “Plan early. Make sure you optimize timelines.” Another emphasized: “Bring all stakeholders to the table as soon as possible to identify risks and objectives.”

Where Confidence Falls Short

• Highly confident: 71%
• Somewhat confident: 24%
• Not at all confident: 5%

• Highly confident: 57%
• Somewhat confident: 33%
• Not at all confident: 10%

• Highly confident: 48%
• Somewhat confident: 38%
• Not at all confident: 14%

Peer Insights

Hospital IT leaders stressed the importance of careful migration partner selection. One survey respondent advised: “Get an experienced partner.” Another was more specific: “Grill the vendor on their migration processes and experiences.”

81% of hospital IT leaders report their budgets for health data management initiatives—including data consolidation, migration, and archiving projects — have increased over the past three years, with one-third reporting significant increases of more than 10%.

Cost, Resource, and Integrity Concerns

• Cost: 100%
• Staff resources: 86%
• Data integrity/loss: 62%
• Downtime: 33%
• Compliance: 19%

Peer Insights

Survey respondents emphasized the critical role of strong organizational structure in addressing cost, resource, and data integrity concerns. One stated: “Ensure you have multidisciplinary project teams with tight governance structure.” Another advised: “Gain executive support, identify your organizational owners, and assist them with execution.”

57% of hospital IT leaders say their organization is increasing spend on EHR-focused projects, such as implementations, migrations, and upgrades, in 2026.

How to Navigate the Top Migration Challenges

Looking for more guidance on EHR migrations? Read our new report: EHR Migration Best Practices: 5 Proven Strategies to Complete Your Project On-Time and On-Budget.

About Harmony Healthcare IT

Introduction:

Insights Grounded in MEDITECH Expertise

This report draws on perspectives from extraction, conversion, and archiving specialists at Harmony Healthcare IT and Blue Elm, a Harmony Healthcare IT company that specializes in MEDITECH data solutions. The combined expertise offers readers a comprehensive view of MEDITECH data extraction challenges and healthcare archiving best practices. 

Referenced survey data come from a survey of CHIME members commissioned by Harmony Healthcare IT and conducted independently by CHIME in November 2025.

Consideration #1: Proprietary Architecture

Many organizations have reached out to us after spending months struggling to extract data because they didn’t partner with specialists with the necessary depth of MEDITECH knowledge and specialized extraction tools.

Consideration #2: Hidden Data Complexity

When you’re archiving data from MEDITECH systems that have been in place for decades, legacy storage formats like tape can be part of that landscape. Our team specializes in understanding, extracting and preserving MEDITECH data to ensure access and compliance.

Consideration #3: Unstructured Content 

Our goal is to preserve the look and feel of unstructured content so archive users see it as it appeared in the native MEDITECH system. If a lab tech is looking at an inquiry report, the content and layout should closely match the MEDITECH output.

Case Study: Magnolia Regional Health Center

When Magnolia Regional Health Center in Mississippi upgraded from MEDITECH MAGIC to 6.1, it faced more than 20 years of legacy data across multiple MEDITECH versions, eight legacy applications, and 350,000+ patient records.

The organization partnered with Harmony Healthcare IT to implement an active archive solution providing patient-centric access with single sign-on from its current MEDITECH system. The solution also included A/R wind-down capabilities, eliminating manual data entry for legacy financial records.

“Harmony’s project management methodology is stellar in the industry,” said Brian Davis, Magnolia Regional Health Center’s CIO. “The team is knowledgeable and passionate about what they do.”

Consideration #4: Customization Management

We often say, ‘If you’ve seen one MEDITECH hospital, you’ve seen one MEDITECH hospital.’ We find something different in every system.

CIOs or CFOs may see the line item for what they’re paying for the legacy system, and they may see the security risk of keeping it around, but they may not fully understand the implications of offlining that system — including who’s using it and in what capacities.

Positioning Your Hospital for Success

Eight Key Questions to Ask When Evaluating Vendors

1. How many MEDITECH archiving projects have you completed across different versions?
2. What extraction methodology do you use — proprietary tools, manual reporting, or RPA?
3. Do you extract directly from transactional environments or rely solely on the data repository?
4. How will users access archived MEDITECH data from our current EHR?
5. What is your approach to data validation and ensuring extraction quality?
6. How do you manage system resources during extraction to avoid disrupting operations?
7. Can you provide references from organizations with similar MEDITECH environments?
8. What is your typical timeline for a MEDITECH archiving project of this size and complexity?

Survey Snapshot: The Growing Case for Legacy Data Archiving

The benefits of a well-executed MEDITECH archiving project extend far beyond compliance and cost savings. Organizations gain improved data accessibility, reduced IT maintenance burden, and the ability to fully decommission legacy systems with confidence. A Q4 2025 survey of 21 CHIME members underscores the growing recognition of legacy data archiving’s value:

When do you anticipate your next legacy data archiving project will take place?

In 2026: 43%
In 2027: 14%
In 2028: 10%
After 2028: 33%

Does decommissioning legacy applications represent a cost savings opportunity for hospitals and health systems?

Yes – Significant or some cost savings opportunity: 19%
Yes – Some savings opportunity: 52%
Yes – Minimal savings opportunity: 10%
No – No savings opportunity: 19%

What are the top factors driving your legacy data archiving decisions?

Cost reduction efforts: 67%
Data access and interoperability concerns: 57%
Security concerns: 52%
IT labor burden concerns: 52%
Compliance concerns: 43%
Inefficient release of information processes: 29%

Source: Q4 2025 Survey of 21 CHIME members commissioned by Harmony Healthcare IT and conducted independently by CHIME.

FAQS

Why is MEDITECH data archiving more complex than other EHR archiving projects?

MEDITECH data archiving is more complex because MEDITECH uses a proprietary architecture with hierarchical data structures that require specialized extraction tools and expertise. Unlike more open EHR platforms, MEDITECH’s unique data formats, particularly in older versions like MAGIC and Client/Server, demand partners who understand the system’s intricacies at a technical level. Standard extraction approaches that work with other EHR systems cannot be used for MEDITECH environments.

How long does a MEDITECH archiving project take?

MEDITECH archiving project timelines vary significantly based on data volume, number of MEDITECH versions involved, level of customization, and ancillary systems that need to be addressed. Organizations with 20-30+ years of data across multiple MEDITECH versions should expect longer timelines.

What should I look for in a MEDITECH archiving partner?

When selecting a MEDITECH archiving partner, look for proprietary extraction tools (not RPA), production environment extraction capabilities, comprehensive understanding of MEDITECH-specific data types (including MTDD and MTA formats), user-friendly archive access with role-based permissions, and integrated archive capabilities with single sign-on (SSO) and EHR integration. Partners should have extensive experience across multiple MEDITECH versions and ideally include former MEDITECH employees on their team.

Can users access archived MEDITECH data from a new EHR system?

Yes, users can access archived MEDITECH data from a new EHR system with the right archive solution. Look for vendors that offer single sign-on (SSO) capabilities and direct integration with your current EHR (such as Epic or Cerner), allowing clinicians to access historical MEDITECH data with a single click from within their current workflow. This integration transforms the archive from a compliance obligation into a valuable clinical tool.

What are MTDD and MTA files in MEDITECH?

MTDD (MEDITECH Text and Document) and MTA (MEDITECH Text Archive) are MEDITECH-specific document formats that combine scanned content with text-based documentation in ways unique to MEDITECH environments. These formats require specialized expertise to extract and preserve properly, as they don’t exist in other EHR systems. Without proper handling, organizations risk losing access to decades of scanned records and clinical documentation.

Should MEDITECH data be extracted from production or the data repository?

MEDITECH data should be extracted directly from production environments rather than relying solely on the MEDITECH data repository (DR). Production environment extraction ensures complete data capture, including information that may not exist in the DR. This approach is considered the most effective extraction methodology by MEDITECH specialists.

What is the difference between proprietary extraction tools and RPA for MEDITECH?

Proprietary extraction tools are specifically developed software designed for MEDITECH environments, offering efficient and accurate data extraction with minimal infrastructure requirements. RPA (robotic process automation) approaches typically involve screen scraping or mimicking user actions, which are more error-prone, time-consuming, require more infrastructure, and increase the chance of incomplete extractions. MEDITECH archiving specialists recommend proprietary tools over RPA.

How much money can hospitals save by decommissioning legacy MEDITECH systems?

Hospitals can save significantly by decommissioning legacy MEDITECH systems through reduced ongoing maintenance fees, server infrastructure costs, IT support resources, and security management expenses. According to a November 2025 survey of hospital CIOs, 65% view decommissioning legacy applications as a cost savings opportunity, up from 58% in 2023. The exact savings vary by organization based on system complexity and age.

Executive Summary

Key Findings

Role Expansions

81% report they are becoming more involved in strategic business decisions.

86% say clinical teams increasingly see the as a strategic partner in ensuring optimal patient care.

62% say their responsibilities are expanding beyond traditional IT functions.

90% say their decision making related to health data management plays a significant role in ensuring optimal patient care.

Room for Growth

Only 33% report they are experiencing more collaboration with the CFO.

Only 10% report they are becoming more involved in M&A activities.

Methodology

The survey of 21 CHIME members took place in October and November 2025. Respondents included CIOs, CTOs, CISOs, and other IT leaders from academic medical centers, integrated delivery networks, community hospitals, and health systems ranging from under $500M to over $10B in annual net patient revenue.

Takeaway #1: A Larger Voice at the C-suite Table

• Greater involvement in strategic business decisions: 81% 
• Greater emphasis on innovation and transformation leadership: 67% 
• Expanded responsibility beyond traditional IT functions: 62% 

Advice from Peers

While this expanded influence brings new opportunities to hospital IT leaders, it also creates new pressures. As one survey respondent noted when asked to share their top advice for peers: “Ensure your voice is heard!” In the year ahead, hospital IT leaders should continue to focus on actively asserting their perspective and advocating for IT’s central role in organizational success.

Takeaway #2: Clinical Impact Takes Center Stage

Do C-suite leaders increasingly recognize the role of IT in clinical outcomes?

86% Yes

14% No

Do clinical teams increasingly see IT as a strategic partner in ensuring optimal patient care?

86% Yes

14% No

Can quality improvement initiatives succeed without direct CIO involvement and leadership?

29% Yes

71% No

Advice from Peers

When asked to share their top advice for peers, many survey respondents emphasized deliberate relationship-building. One respondent stated simply, “Collaborate with clinical,” while another emphasized, “Partnership is key.” 

Top 2026 Investment and Budget Priorities

As hospital IT leaders expand their influence, where are they directing resources? The survey reveals spending priorities that align with industry changes: investments in AI and automation, cybersecurity protection, and data management initiatives that support clinical care and operational efficiency. 

In which of the following areas do you anticipate your organization will increase IT spend in 2026? (respondents could select all that apply)​

• AI/automation: 76% ​
• EHR-focused projects (implementations/migrations): 57% ​
• Cybersecurity: 52% ​
• Legacy system consolidation/data archiving: 38% ​
• Compliance: 10% ​

What are your top data management priorities for 2026? (respondents could select top 3)​

• Cybersecurity/compliance: 86% ​
• Legacy system consolidation/data archiving: 71% ​
• EHR implementation/conversions/migrations: 62% ​
• Interoperability enhancements: 57%​
• ERP implementation/conversions/migrations: 24% ​

How has your IT budget for health data management initiatives (i.e., data consolidation, migration, and/or archiving projects) changed over the past 3 years?​

• Significantly increased (more than 10%): 33% ​
• Moderately increased (up to 10% increase): 48% ​
• Somewhat decreased (up to 10% decrease): 10% ​
• Significantly decreased (more than 10% decrease): 10%​

Takeaway #3: IT Influence Lags in Two Key Areas

In the past three years, have you experienced more collaboration with your CFO?

Yes 33%

No 67%

In the past three years, have you experienced more involvement in M&A activities?

Yes 10%

No 90%

Advice from Peers

Survey respondents emphasized the need for stronger C-suite partnerships and clearer communication of IT’s value. One counseled: “Partner with the CISO/CFO and executive team to educate them on the risk associated with not investing in IT and cybersecurity.” Another advised: “Help the organization embrace technology changes that actually have real ROI, and help key leaders take ownership in the outcomes.”

The Path Forward

About Harmony Healthcare IT

Introduction:

On the Line: Operational Challenges, Patient Care Disruptions, and Wasted Resources

The stakes for EHR migration projects couldn’t be higher. Delayed or failed migrations can disrupt hospital operations and compromise patient care. They can also consume valuable resources that many organizations cannot afford to waste, particularly as concerns mount about the financial impact of the “One Big Beautiful Bill.” Read our new report to learn more about the federal legislation, how it could affect your hospital, and three actions IT leaders can take now to prepare.

Best Practice #1: Capture Cross-Functional Input — From the Start

Without Early Cross-Functional Team Involvement, Your Project Risks:

• Underestimated timelines and budgets   
• Overlooked specifications and requirements 
• Misaligned expectations with executive leadership  
• Poor stakeholder engagement and buy-in 
• Staff resourcing challenges during critical phases

Best Practice #2: Consult with a Migration Partner — As Early as Possible

Three key benefits of early engagement with a migration partner:

1. More comprehensive planning and timeline management.

2. Earlier identification of time-sensitive activities. 

3. Improved stakeholder communication strategies.

Understanding Your Options: Protecting the Heartbeat of Your Business

Hospitals and health systems have multiple options when it comes to migration and archiving timelines, and some are more comprehensive than others. While some vendors offer accelerated approaches that might work in certain situations, these approaches also include trade-offs that healthcare IT leaders should understand before committing.  

More limited approaches may migrate and/or archive certain data types while excluding others, such as treating unstructured documents like scans and images as a different workstream. Your data is the heartbeat of your business, and these scope decisions can directly impact clinical workflows, compliance requirements, and accessibility. More limited approaches may even result in lost data that can never be recovered.   

An experienced migration partner understands the gaps and challenges that come with each approach. Rather than offering the fastest option, they’ll help you evaluate what matters most for your organization and what timeline best supports your unique needs and budget. 

• Create combined and comprehensive migration and archival goals and measurable success criteria 
• Determine which data should be migrated, archived, and/or purged 
• Develop compliant, secure, and accessible archiving processes  
• Execute your archiving system rollout and efficiently migrate your data  
• Identify additional legacy systems for decommissioning and archive integration 

Inside Legacy Data Archiving: Insights from a Health System Leader

David Winn, VP of Information Services at Parkview Health, has helped dozens of organizations transition to Epic through the Parkview Connect program — including navigating the complex decision-making around legacy data archiving.
Some of his top priorities when planning archiving projects? Focus on cost savings, ensure single sign-on integration with the EHR for clinical access, make it user-friendly for HIM teams, and don’t overlook the accounts receivable component. Winn recently shared detailed archiving strategies with Harmony Healthcare IT. Read the Q&A.

Best Practice #4: Plan for — and Protect — Your Internal Resources

Three strategies our migration experts recommend for managing internal resource constraints:

1. Map out every staffing need at every phase. Work with your migration project team to create detailed documentation of the internal and external resources that will be needed during each phase. While this may seem like a big lift, keep in mind that a strong migration partner will provide you with a detailed resource and infrastructure planning framework.  

2. Communicate early and frequently. After mapping out your phase-based staffing needs, share it with corresponding department leaders and discuss how their team members will be impacted. Then, throughout your project, provide department leaders with regular updates regarding upcoming resource needs and timing.

3. Discuss resource gaps with your migration partner. While working through those two steps, you may find that you will need external resource support during certain project phases. The best migration partners will be able to recommend solutions and provide additional expertise and specialized skills as needed.

Transitioning to Epic? A Key Resource to Consider

Epic-Bridges certified experts are crucial if you are engaging in an Epic migration. These individuals have completed extensive specialized trainings on building interfaces, loading data, proactively resolving problems, handling and triaging dashboard warnings, and more. When evaluating migration partners for an Epic implementation, make sure to prioritize partners who employ Epic-Bridges certified experts. 

Best Practice #5: Build Your Data Conversion Working Environment — Within Your Own Infrastructure

• Detailed infrastructure diagrams showing optimal set up configurations 
• Technical planning discussions to help prepare and configure your environment 
• Pre-configured virtual server images with software and proprietary tools pre-loaded (if your virtual environments are compatible) 

How One Organization Decreased Its Migration Project Timeline by 16 Weeks

Harmony Healthcare IT recently supported a hospital migration project during which the hospital opted to set up the data conversion environment within their own system. The impact? The overall migration timeline decreased by 16 weeks, says Mais. “This can be a game-changing strategy for organizations seeking to accelerate their project timelines.”

Moving Forward with Confidence and Speed

FAQS

What's the biggest mistake hospitals make during EHR migrations?

Two of the most common mistakes hospitals make during EHR migrations is (1) waiting too long to engage cross-functional teams and (2) waiting too long to engage EHR migration partners. This leads to underestimated timelines, overlooked requirements, and resource conflicts that could have been prevented with early planning. Starting these conversations a few months before your planned migration can save significant time and costs.

Should my hospital handle an EHR migration internally or work with an external partner?

While some aspects can be managed internally, the complexity of modern EHR migrations typically exceeds internal IT capabilities, especially around data extraction, conversion and compatibility issues. External partners bring specialized tools, proven methodologies, and experience from hundreds of similar projects. Most successful organizations use a hybrid approach, maintaining internal project leadership while leveraging external expertise for technical execution.

What's the most resource-intensive part of an EHR migration?

Several aspects are resource-intensive, but data mapping and conversion often require the most resources. Proper resource planning for this phase is important to avoid project delays.

How do we help our hospital staff adopt our new EHR successfully?

Early engagement and comprehensive training are essential for successful EHR adoption. Include clinical representatives in your migration team from Day 1 to address concerns and verify that the new system meets workflow needs. Create “super user” champions who receive advanced training and can support their colleagues during the transition.

What compliance considerations should we address during migration?

Data security, patient privacy, and regulatory compliance must be maintained throughout the migration process. Your migration partner should provide detailed security protocols and support adherence with all regulatory requirements. Document all compliance measures for potential audits.

What should my hospital look for when selecting an EHR migration partner?

Choose partners with extensive experience in your specific legacy EHR system and go-forward EHR. They should provide detailed project timelines, proven methodologies, and references from similar organizations. Look for partners who offer both migration and archiving services for comprehensive support.

Executive Summary

Historic Medicaid cuts. Skyrocketing uninsured rates. Billions in uncompensated care.

• Reduced hospital service lines and staffing,
• Longer emergency department waits, and
• Facility closures, particularly in rural and underserved areas.
  

1. Prioritizing initiatives with near-immediate ROI potential, which could help offset the financial impact of the legislation. 
2. Preparing for potential M&A activity that could arise due to the legislation and its ramifications.
3. Developing strategic AI implementation plans to realize new efficiency gains and cost savings amid escalating financial pressures.

This report examines each of these action items in more detail, providing CIOs and other IT leaders with practical approaches and guidance to address them strategically.

The question for CIOs and IT leaders isn’t whether their organization will be affected by the legislation — it’s whether they will step forward to lead a strategic response that helps their organization overcome the challenges.

Hospitals Under Pressure: 3 Data Points to Know

14 million more individuals projected to be uninsured by 2034 

• 10 million from Medicaid/ACA changes included in the “One Big Beautiful Bill”  
• 4 million from expiring enhanced premium tax credits for ACA exchange plans 

Source: Kaiser Family Foundation

• Likely impact: 

• • More patients delaying care 
  • More patients utilizing the emergency department 
  • More billing and collections confusion  
  • More uncompensated care 

$1 trillion in federal healthcare spending cuts 

• Including at least $940 billion in Medicaid cuts (widely cited as the largest cut in program history) 

Source: Advisory Board

• Rural hospitals face the greatest risk: 92 have already closed over the past decade. While the legislation includes a rural health fund, it is projected to offset only about one-third of estimated cuts to Medicaid in rural areas.

Sources: American Hospital Association, KFF analysis 

$85 billion projected increase in hospital uncompensated care (2025-2034)

• Total uncompensated care, across all facilities, could increase to $283 billion due to the legislation and the expiring ACA exchange plan tax credits. 

Source: The Urban Institute

Action #1: Identify and Pursue Initiatives with Near-Immediate ROI Potential

Recommended Focus Areas:

• Eliminating waste
• Optimizing existing resources 
• Enhancing operational efficiencies

Opportunities to Consider: 

• Enhancing your revenue cycle management (RCM) optimization technology. Advanced RCM solutions, such as those that incorporate AI, real-time data analytics, and predictive insights, provide significant opportunities to streamline workflows and optimize revenue. Now may be the time to consider whether your RCM technology is fully optimized.
• Reassessing your administrative efficiency-enhancing technologies. While most organizations have already implemented several solutions that fall under this umbrella — including scheduling, communication, inventory management, and data analytics tools — not all are continually re-evaluating these solutions to ensure optimal impact. Now may be the time.
• Crafting a strong legacy data archiving strategy. In addition to ensuring better data availability, integrity, security, compliance, and usability, legacy data archiving unlocks significant cost and efficiency savings, often delivering ROI within the first year. Data archiving vendors may offer flexible financing terms to best meet the needs of the organization, such as SaaS pricing models.  

The ROI associated with legacy data archiving is driven by two key areas: 

1. Cost savings due to decommissioned systems. A strong archiving solution enables organizations to store historic data in one comprehensive system, rather than paying for licensing fees, maintenance, specialized support, and infrastructure for multiple systems. For many organizations, this amounts to significant cost savings, as it did for one large health system, which saved $3 to $4 million in annual maintenance costs after implementing an archiving solution. 
2. Cost savings due to more efficient processes. Best-in-class archiving solutions empower organizations to quickly and easily access legacy data. This makes it easier for teams, such as health information management (HIM), compliance, and finance, to navigate the system and respond to data needs and requests. A comprehensive archive also benefits the clinical team, as they can easily access legacy patient records when needed. 

Hospitals Plan IT Investments Despite Financial Challenges

A July 2025 KLAS Research report found that despite federal policy uncertainty and financial pressures, more healthcare organizations plan to increase their IT spend over the next 12 months than decrease it. Overall: 

• 42% of healthcare organizations plan to increase IT spend 
• 33% will keep it the same 
• 25% will decrease it* 

“These numbers tell us that healthcare leaders are making calculated decisions,” says Dan Czech, Vice President of Insights at KLAS. “Even with significant policy pressures ahead, many organizations see technology as part of the solution, not something to cut back on.”

*Source: “Navigating the Uncertainty of Federal Policy 2025,” KLAS Research, July 2025.

Hospital Leaders Weigh In: The Value of Legacy Data Archiving

“We’ve had a significant six-figure ROI in hard dollars. These are dollars we were paying for Microsoft licensing, legacy maintenance fees, server costs … That doesn’t even begin to look into the soft-dollar ROI — the efficiency gains, having one source of truth, single sign-on, easier for HIM to access for release of information.”  

• Sidney Dixon, VP, Chief Applications Officer, Tower Health

“The ROI from legacy data archiving comes from two sources: direct cost savings from system decommissioning, and operational efficiencies. HIM teams and clinicians save significant time when they can access all historical patient data from a single platform rather than navigating multiple legacy systems.”

• David Winn, VP, Parkview Connect & Corporate HIM Operations, Parkview Health

Action #2: Prepare for Potential M&A Activity

Four Steps to Take: 

1. Assess your data governance team. In the event of M&A activity, this group will be integral to navigating data integration planning and process-related questions that arise. If you don’t already have a data governance team in place, take the time now to form one. It should include representation from HIM, finance, clinical, operations, legal, compliance, risk management, IT, etc. 
2. Review and document your data sources and systems. A merger or acquisition will impact every area of your business, including all data sources and systems. Conduct a thorough review now of all data sources and their storage locations to ensure you have updated documentation. This will save significant time if your organization is impacted by an M&A in the coming months. 
3. Prepare for data migration needs. One of the biggest challenges in an M&A scenario is integrating different IT systems. The complexity is compounded when the merging organizations have different EHR platforms. Develop a strong plan now for how you will approach an EHR migration project, should the need arise.
4. Plan for legacy data archiving and legacy system decommissioning. Ensuring you have a strong data archiving and system decommissioning plan is just as critical as creating a strong data migration plan. Not only will developing strategies for M&A-related archiving projects save you time later, but preparing in advance can unlock significant savings when proactively planning around legacy renewals and extract timelines. 

• Early involvement in any M&A evaluations or decisions 
• Strategic input related to M&A-related technology and data integration decisions and vendor relationships
• Adequate resources and timelines for M&A-related data migration, legacy data archiving, and legacy system decommissioning projects

The Medicaid cuts are going to force small community hospitals to either shutter their doors — which will be detrimental to the communities they serve — or they’re going to have to align, either through joint ventures or acquisitions, with larger systems. It’s hard to say how quickly the pace will pick up, but I think we’re likely to start seeing a lot more M&A activity. I would strongly encourage CIOs and others to be thinking about archiving and migration partners that have deep experience with M&A-related migrations. Having partners that can jump in quickly will be important.

The Added Complexity of M&A Data Migrations

Migrating data from one EHR to a brand new EHR is challenging alone, but, migrating data from one EHR into an existing go-forward EHR (as typically occurs during M&As) is even more complex. In this scenario, some patients may already exist in both the legacy system and the go-forward EHR, so the migration will require not just moving data to the new system but reconciling items like medication lists and allergies, comparing legacy EHR values to go-forward EHR values. The task is further complicated by the fact that medications, for example, can be referenced by brand names or generic names, making a match that much more difficult.

Industry Shifts: Closures and Consolidations

Augusta Health, based in Virginia, recently announced plans to consolidate three care sites—Buena Vista Primary Care, Churchville Primary Care, and Weyers Cave Urgent Care — into other existing service locations. In a public statement, Augusta Health referred to the recent passage of the “One Big Beautiful Bill Act” as a factor influencing the decision. 

Action #3: Develop a Strategic Plan for AI Implementation

Among the report’s key findings:

75% of C-suite leaders believe AI reduces operational costs through greater efficiencies

66% are investing in AI solutions to streamline administrative operations

57% say AI solutions are among their top five tech priorities over the next two years

Yet, the data also point to significant challenges and adoption barriers:

Only 13% have a clear AI integration strategy

Only 12% believe AI algorithms are robust enough to rely on

Only 10% are aggressively pursuing AI solutions

The rapidly evolving nature of AI can make crafting a strategic implementation plan daunting, but getting started is crucial. Organizations that lack a clear strategic plan will struggle to identify high-value use cases, measure ROI, and avoid costly mistakes.

Opportunities to Consider: 

• Appointment scheduling, check-in, and registration 
• Benefits eligibility verification and patient payment estimation  
• Predictive maintenance for medical devices 
• Supply chain management 

AI Investment Trends for 2026

Focus on AI-driven transformation with strong governance and cybersecurity, while building a culture that’s agile, data-driven, and relentlessly centered on patient and consumer value.

Spotlight On Rural Hospitals

How an EHR-sharing program is helping to offset financial challenges

Healthcare access and inequity barriers continue to plague rural areas of the United States — and recent legislation could exacerbate these issues. The Congressional Budget Office estimates that the “One Big Beautiful Bill” could result in millions of Americans losing Medicaid coverage by 2034. Rural healthcare facilities, nearly half of which are already operating at negative margins and which heavily rely on Medicaid reimbursement, may be forced to cut back on services or shut down entirely.

• 48% of rural hospitals operated at a financial loss in 2023
• 92 rural hospitals have closed their doors over the past 10 years
  • Source: American Hospital Association 

As rural hospitals navigate the new legislation and its potential ramifications, EHR sharing programs could help offset some of the financial challenges they are facing. One example is the Parkview Connect program, led by UpVia Health and hosted through Parkview Health, a community-based health system serving Northeast Indiana, Northwest Ohio, and Southern Michigan. 

Through the program, which is part of the Epic Community Connect initiative, Parkview Health shares its full Epic EHR capabilities with independent clinics, no-charge and FQHC clinics, and rural healthcare and hospital facilities in the region at a significantly reduced cost. 

“It’s almost impractical for small, rural community hospitals to be able to afford a whole new EHR like our larger system has,” says David Winn, VP, Parkview Connect & Corporate HIM Operations. “The sharing works out very well with tremendous benefits for the physicians, community, and the patient population.” 

In addition to helping rural organizations navigate economic hardship, the Parkview Connect program enhances interoperability and patient information sharing throughout the region. Currently, nine hospitals, dozens of hospital-owned clinics, 23 independent clinics (including specialty clinics and free clinics), and FQHCs are part of the program.

Watch this video to see David Winn’s full interview on the benefits of Parkview Connect. 

Act Now for Long-Term Success

About Harmony Healthcare IT