Migrating EHRs can be one of the most complex and risky undertakings for physician groups and ASCs. Data integrity, regulatory compliance, contract terms, and clinician workflow all hang in the balance.
During a December webinar hosted by Becker’s Healthcare, leaders from MediQuant and Prince George’s County Health Department shared hard-earned lessons on how ambulatory practices can navigate EHR transitions without derailing operations.
Wayne Trochmann, Corporate Director of Partnerships at MediQuant, and Mantai Murry, Head of IT at Prince George’s County Health Department in Maryland, outlined practical strategies rooted in real-world migration experience, including Prince George’s County’s move from four legacy EHRs.
Below are five key takeaways from the discussion.
Note: Quotes have been edited for length and clarity.
1. Read legacy EHR contracts early and carefully
One of the most common migration pitfalls begins long before go-live. Mr. Trochmann urged organizations to thoroughly review existing EHR contracts to understand term lengths, auto-renewals, notification requirements and data-access provisions. He described situations where organization leaders thought they were at the end of a contract, only to realize they had auto-renewed for another multiyear term.
Without proper planning, practices can be forced into costly extensions if data conversion is delayed or go-live timelines slip. Clear guardrails and timelines are essential to avoid last-minute renegotiations and inflated fees.
2. Vendor relationships often change once notice is given
Notifying a legacy EHR vendor of an impending exit can fundamentally alter the working relationship. Ms. Murry said Prince George’s County experienced slower data access, reduced transparency, and more rigid communication once vendors learned the organization was moving on.
“It became a whole different ball game [once we notified them],” she said. “Everything had to be in writing, and they tried to prolong the timetable to give us the data;it became more challenging to get data dictionaries and timelines we needed.”
Ambulatory leaders should anticipate friction and build contingency plans — including read-only access or third-party extraction support — to keep projects on track.
3. Converting everything is rarely the best strategy
Data migration decisions should balance clinical value, regulatory requirements and cost. One best practice, Mr. Trochmann said, is to convert one to three years of recent data and archive the rest.
Ms. Murry said Prince George’s County converted three years of data while archiving older records to meet retention requirements, particularly for pediatric patients. Linking archived records directly within the EHR preserved clinical access without overwhelming the new system.
4. Strong project management and IT leadership are nonnegotiable
Even with cooperative vendors, migration timelines can collapse without internal readiness. Ms. Murry emphasized that organizations need experienced IT leadership and realistic project plans to counter delays caused by data cleanup, mapping, and training demands.
“Without good IT representation, vendors can run circles around organizations and make them feel like they need to be with them forever,” she said.
Dedicated project management, clear roles, and disciplined testing cycles helped Prince George’s County stay on schedule despite juggling four legacy EHRs.
5. Contracting should align with long-term flexibility
Both speakers stressed that contracts with EHR and archiving vendors should reflect organizational realities, including budget constraints and regulatory risk.
Mr. Murry advised leaders — particularly in government and safety-net settings — to include termination clauses tied to funding changes and performance guarantees tied to service-level agreements.
Bottom line
EHR migrations are not just technology projects — they are legal, operational, and cultural transformations. Ambulatory leaders who plan early, limit data conversion scope, and lean on experienced IT teams can reduce disruption and effectively advance the transition.
MediQuant helps healthcare organizations of all sizes efficiently transition EHRs without carrying unnecessary legacy burden. Talk with us today.
