Introduction
Healthcare is entering a period of significant system transition, with nearly 4 in 10 hospital IT leaders reporting that their hospitals are planning an EHR migration project in 2026. That’s according to a late 2025 survey of 21 CHIME members.
EHR migrations represent some of the highest-stakes projects hospital IT leaders undertake. Done well, they can improve clinical workflows, enhance data accessibility, and increase efficiencies. Done poorly, they can result in cost overruns, data loss, compliance problems, and patient safety risks.
The survey findings suggest that while hospital IT leaders understand what’s at stake, many are heading into these projects with concerning gaps in confidence and preparation.
Read on to learn what’s driving EHR migration activity, where confidence gaps exist, and how hospital IT leaders can ensure successful transitions.
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
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.
Migration Activity and Drivers
Nearly 40% of hospital IT leaders are planning EHR migration projects in 2026, and of those, about half anticipate their initiative will begin in the first half of the year.
When will your next EHR migration/transition project occur?
- 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%
What do you think will most drive the need for that project?
- Merger and/or acquisition: 38%
- New EHR implementation: 33%
- Other: 29%
Other responses included system optimization and related enterprise software initiatives.
Overall, 62% of all respondents cite EHR implementations, conversions, and migrations as one of their top 3 data management priorities in 2026 — reflecting not just the 38% actively executing projects this year, but also the 24% planning for 2027 migrations.
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
Hospital IT leaders express reasonable confidence in their ability to meet migration timelines, but that confidence erodes when asked about budgets and avoiding major problems.
How confident are you that you can complete migration projects ….
On-time:
- Highly confident: 71%
- Somewhat confident: 24%
- Not at all confident: 5%
On-budget:
- Highly confident: 57%
- Somewhat confident: 33%
- Not at all confident: 10%
Without major problems:
- Highly confident: 48%
- Somewhat confident: 38%
- Not at all confident: 14%
Only 48% are highly confident they can complete migrations without encountering problems such as unexpected downtime, data loss, or compliance issues — meaning most hospital IT leaders are heading into high-stakes projects expecting significant challenges.
The budget confidence gap is also concerning, with only 57% highly confident they can stay on-budget. That’s particularly notable given that 81% report their budgets for health data management initiatives have increased over the past three years. The persistent budget concerns, even amid increased investment, reflect the escalating complexity of EHR migrations and the specialized expertise they require.
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
When hospital IT leaders identify their top concerns about migration projects, three challenges dominate: cost, staff resources, and data integrity.
What are your top 3 migration project concerns?
- Cost: 100%
- Staff resources: 86%
- Data integrity/loss: 62%
- Downtime: 33%
- Compliance: 19%
Every hospital IT leader surveyed cited cost as one of their top 3 concerns. Costs tend to spiral for reasons that include unexpected vendor fees for additional work or services, increased internal resource demands, and delays that prevent timely legacy system decommissioning.
Staff resource concerns, cited by 86% of respondents, rank nearly as high. Migration projects require support from not just IT, but from clinical, HIM, legal, and compliance teams, all while these individuals manage their day-to-day workloads.
Data integrity and loss concerns, cited by 62% of respondents, reflect the high-stakes nature of these projects. Incomplete or inaccurate data migrations can create confusion, inefficiencies, and jeopardize patient care.
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
The survey reveals where hospital IT leaders face the greatest challenges during migration projects. Based on these findings, here are four strategies to enhance confidence and address the most common concerns:
Partner Right to Stay on Budget
If you’re among the 100% of hospital IT leaders with cost as a top concern: Seek out an experienced migration partner that can provide realistic cost expectations based on your unique needs and circumstances. When evaluating potential partners, ask about their approach to scope management and how they prevent unexpected costs from emerging later in the project. Also ask references if and why they experienced any unexpected costs during their projects.
Plan Ahead to Address Resource Constraints
If you’re among the 86% concerned about staff resources, work with your migration partner to create detailed documentation of internal and external resources required during each phase of your project. Once that information is compiled, discuss external resource needs with your migration partner and provide regular updates to department leaders to help them plan internal resources around competing demands.
Prioritize Partners That Ensure Data Quality
If you’re among the 62% with data integrity concerns, prioritize partners that can provide detailed information on their data integrity strategies. Ensure the partner has deep experience with your specific source and go-forward EHRs, follows proven validation processes, and provides transparency into data quality issues if they emerge.
Engage Migration Partners Early
If you’re among the 52% who aren’t highly confident about avoiding major problems, consult with a migration partner as early as possible. Early partner engagement helps identify time-sensitive activities — like vendor data release requests that can take months to fulfill — before they become project delays. Experienced partners can also help you communicate more effectively with stakeholders about upcoming challenging phases, maintaining confidence and buy-in throughout the project.
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
Harmony Healthcare IT is a data management firm that transforms critical data into secure, compliant, and accessible assets — whether that is converting data to a new platform or securing it in an archive. Since 2006, we have worked with over 700 healthcare software platforms across clinical, financial, and administrative systems. Our commitment to reliability and innovation empowers healthcare organizations to manage their data with confidence.
