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Migrating a 15-Year-Old Hospital EHR Without Losing a Single Patient Record — Or a Single Day of Operations

Key Outcome
100%
data match rate — zero patient records lost
Team
18 engineers
Timeline
16 weeks
Industry
Healthcare
01The Situation

A 400-bed community hospital in the southeastern US. $620M annual revenue. They had been running a legacy EHR system — installed in 2009 — that the vendor had officially end-of-lifed. No more patches. No more compliance updates. The system worked, but it was a ticking regulatory time bomb.

02What Changed

The vendor's end-of-life announcement gave them 14 months to migrate. They engaged a national consulting firm for the migration planning. Eight months and $1.2M in consulting fees later, they had a 200-page migration roadmap and zero lines of code. The CFO calculated that at the current burn rate, they'd spend more on the migration plan than on the migration itself.

03Why The Algorithm

Referral from their health system's CIO network. They needed a team that would build, not plan.

04What We Built

Full EHR migration — 15 years of clinical data, 1.8M patient records, 340M clinical observations — migrated to a modern FHIR-native platform. Data validation engine ensuring zero data loss with automated reconciliation checks. New clinical interfaces deployed in phases to minimize clinician disruption. Legacy system ran in parallel for 30 days as a safety net — zero discrepancies found.

05 — The Result

Zero patient records lost. Zero days of clinical downtime. The parallel run period ended with a 100% data match rate. Annual EHR maintenance costs dropped by 60% because the new system ran on modern infrastructure with SentienGuard monitoring instead of requiring a dedicated support team for a legacy platform.

Facing a Similar Situation?

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