It is no secret that technology advances at an ever-increasing pace. Especially in healthcare, optimistic investments in innovations in both hardware and software are commonplace.
However, an interesting data point for 2024 has emerged. A study found that integrating and modernizing systems like electronic health records (EHRs) and improving cybersecurity infrastructure were top priorities. If one includes the need to digitize and provide virtual care, these issues made up 85% of the digital and technology budgets of surveyed organizations. [1]
In this environment, the clear trend is modernizing existing systems and improving existing infrastructure to match new developments. Consequently, it is no wonder that a central topic of discussion is the need for legacy system migration
For this article, we interviewed one of our BGO experts, Bozhidar Markov – an R&D manager who specializes in .NET Technology. With his help, we will reveal the secrets of the migration of legacy systems in healthcare as well as give you some tips and tricks for doing it.
Introduction to legacy systems in healthcare: challenges and risks
Legacy systems in healthcare refer to outdated software that still supports critical business operations, often due to deep integration into workflows built over years or decades. It is difficult to give a definition of a “legacy system”, but our expert provided some markers to identify such a system:
“A technology can be seen as “legacy” from several different aspects. That technology can simply no longer support the number of patients because it is limited by its scalability. Technologies can also be classified as “legacy” by regulations which mandate updates. Lastly, it may simply not be able to accommodate security standards and thus require replacement.”
- Bozhidar Markov
Thus, whether you are experiencing interoperability issues or need to update existing tech for regulatory of security reasons, this article has the answer.
Issues with using legacy systems
While familiar, these systems pose major challenges. Modern technologies often don’t work with them, making interoperability more of an aspiration than a reality with newer technologies. A common issue is processes being disjointed, forcing staff to fix issues by hand or manually input data. Furthermore, legacy systems are rarely scalable, making it challenging for organizations to respond to changing healthcare requirements.
The risks for healthcare providers can be significant when they operate on legacy systems. If certain software is no longer supported, it will not receive any more updates, which makes it more susceptible to a security breach, and sensitive patient data can be at risk. Most legacy systems have not benefitted from ongoing, regular updates and vendor support, leaving them vulnerable to emerging security risks. Moreover, these systems are also costly to maintain, as they need expertise and come with frequent technical glitches. Without modern features like real-time data analytics or cloud-based accessibility, it can impede decision-making and patient care. Therefore, the transition from legacy systems is beyond a technology upgrade but rather a strategic requirement for healthcare organizations.
Types of systems that are most frequently migrated
Healthcare organizations often migrate a variety of systems and devices to modern platforms to improve efficiency, security, and patient care. Below are the most migrated systems and devices:
- Electronic Health Records (EHRs): Legacy EHR systems are among the most commonly migrated applications because they are at the heart of patient care. Many legacy systems are not interoperable, preventing data from being shared between departments or with outside providers. They may also fall short of contemporary regulatory requirements, like HIPAA or GDPR.
By moving to newer EHR systems, data is more accessible, better patient outcomes are achieved, and compliance is ensured. Modern EHRs also support advanced features such as real-time analytics, telehealth integration, and patient portals, which are critical for providing high-quality care;
- Customer Relationship Management (CRM) systems: CRMs are essential to manage patient interactions, appointments, and follow-ups. Many older CRM systems are not flexible enough to adapt to modern-day integrations and personalized patient engagement. While legacy CRMs serve the purpose of large enterprise-scale marketing and sales, the new-age CRMs cater to the need for integration and scalability.
- Medical imaging systems: tools such as MRI, CT scanners, and X-ray machines are still using legacy software that restricts data sharing and storage. Some legacy imaging systems produce proprietary formats that cannot be read by contemporary diagnostic software or cloud storage.
These systems must migrate within EHRs for seamless data integration and enhanced diagnostic accuracy, while securing storage at scale. Advanced imaging features, such as 3D imaging and AI-powered diagnostics, are also supported by modern imaging systems, which help to improve patient care;
- Telemedicine platforms: as the telehealth boom took off, healthcare providers had to upgrade or migrate their older telemedicine systems. Legacy systems often have limited functionality, and compatibility issues with modern devices.
New telemedicine platforms support real-time consultations, are also more accessible, and help improve remote patient monitoring. Newer trainers can hook into EHRs and even wearables to deliver a full view of a patient’s health;
- Laboratory Information Systems (LIS): Legacy LIS systems are often migrated as a means to enhance data accuracy and streamline lab workflows. Older systems are not always integrated with EHRs or other diagnostic tools, causing delays or errors in test results.
Modern LIS systems offer features such as automated data entry and easy interoperability with other healthcare systems. This naturally means faster turnaround times, and easier collaboration between labs and clinicians, leading improved patient outcomes;
- Pharmacy management systems: Pharmacy management systems are used to migrate outdated pharmacy systems, helping in upgrading medication tracking and inventory management. An old system might not have features such as e-prescribing, drug interaction alerts, or integration with EHRs.
In other words, modern pharmacy management systems help normalize workflows, and comply with regulatory requirements. They furthermore back patient-facing measures such as medication reminders and refill requests.
- Wearable devices and IoT devices: Wearable health monitors and other IoT devices are increasingly being transitioned to modern platforms. Legacy devices are often unable to integrate with new healthcare systems or cloud services.
The migration of these devices allows for live data collection and improved patient monitoring. Newer wearables and IoT devices are also capable of advanced analytics, which allows for proactive, data-informed care by healthcare providers;
- Administrative and billing systems: Legacy administrative and billing systems are often migrated so as to reduce errors, improve efficiency, and ensure compliance with evolving regulations. Legacy systems can struggle with complex billing processes or modern payment platform integrations.
Adapting to a new system helps streamline the whole revenue cycle management. This means – minimizing claim denials and increasing financial transparency. Other new systems support automated invoicing and patient payment portals to improve the financial experience for both types of consumers;
- Cloud-based storage and backup systems: A lot of healthcare providers are transitioning from on-premise storage to a cloud platform. Storage limits are enhanced with cloud migration in healthcare, especially since they allow one to access data from anywhere, save on costs, and provide extremely safe storage.
Data is more secure when migrated to the cloud, with better disaster recovery, and also in compliance with data protection regulations;
“The transition to cloud computing is more than a technical upgrade; it represents a strategic shift in operational efficiency and agility.”
- Bozhidar Markov
- Patient portals: Many legacy patient portals are replaced in favor of providing an improved user experience and better patient access to their health information. Older portals may not offer features such as mobile compatibility, secure messaging, or EHR integration.
Today’s patient portals allow patients to retrieve test results, schedule appointments, and communicate with providers with ease. These technologies have the potential to boost patient engagement and satisfaction while lessening the administrative load on healthcare personnel.
The migration of these systems and devices can therefore enable healthcare organizations to optimize their business in almost any aspect. The crucial question is how to facilitate this transition.
Key considerations in healthcare legacy system migration
There are many such factors that need to be accounted for. They range from regulatory compliance and data integrity to stakeholder engagement.
“Every aspect of the transition must be carefully planned. A clear roadmap is essential for successful adoption.”
- Bozhidar Markov
Building on this insight serves as a foundation for migrating with success from legacy systems to new solutions. Just some of the factors that a company must carefully examine include:
Regulatory compliance
Healthcare legacy system migration often involves regulatory compliance as a crucial factor. They should also ensure that the new system complies with standards such as HIPAA, and GDPR, among various regional regulations, to safeguard patient data and avoid legal penalties. Failure to comply can lead to data breaches, fines, and damage to the organization’s reputation. Our expert warns that simply developing a software is not enough
Organizations can ensure compliance throughout the healthcare legacy system migration process by first creating a complete audit of existing systems to determine where they don’t fully comply with regulations.
“Before software can be used, it must undergo software validation to ensure no data was corrupted during migration or that there are no vulnerabilities in the software. Only after the software is validated and the regulator has approved its use can the software be used.”
- Bozhidar Markov
The software is further enhanced by compliance implementations with appropriate data encryption, access controls, and audit trails all baked into the new system. Furthermore, post-migration, regular testing and monitoring need to regularly confirm that you continue to meet all regulatory requirements.
Data integrity and accuracy
Our expert underscores that one of the most important aspects of the legacy data migration process is that there is no loss, corruption or alteration of data. Data transfer errors can result in incorrect diagnoses, treatment delays, and errors in patient care – all of which could be fatal. To preserve data quality, organizations must implement thorough data mapping and standardization practices, which ensure that the new system accurately reflects the existing data. Such a cautious strategy reduces threats and facilitates uninterrupted delivery of treatment and administrative services.
Integrated and interoperable
Interoperability and integration are key in ensuring the new system integrates well with existing systems and modern technologies. Our expert warns that oftentimes older software simply does not have the infrastructure to handle the users needs. Legacy systems are notoriously siloed, making it hard to share data between departments or with outside providers.
Moving to a more interoperable solution will enable healthcare transformation by lowering costs and improving efficiency and outcomes. Ensuring that data is available and accessible to the EHRs, diagnostic tools, and other platforms creates a unified environment that fosters data-driven decisions and operational efficiency.
Stakeholder involvement
Engaging with stakeholders is vital for the success of the migration plan of any healthcare legacy system. Working closely with clinicians, administrators, IT staff and patients early in the process ensures the new system is appropriate for all user types.
Their involvement clarifies potential roadblocks like adoption troubles and workflow disruptions and then makes sure that the migration aligns with organizational objectives. Collaboration and communication is key when healthcare providers want to build trust, facilitate the transition, and optimize the adoption and potential effectiveness of the new system.
Downtime minimization
Minimizing downtime is prioritized during healthcare legacy system migration since a short stop can compromise patient care and business operations. To minimize downtime, organizations can employ tactics such as a parallel migration in which the old and new systems operate in parallel, or a phased migration approach in which components are transferred incrementally.
Thorough testing as well as migrating in off-peak hours also help reduce disruptions. Minimizing downtime is crucial for healthcare providers to ensure operational continuity and maintain trust with patients and staff. However, there are still some issues.
Typical problems when migrating a healthcare systems
Despite following all of the key steps to modernize legacy systems, a hospital may still have some challenges. It must keep all of them in mind – avoiding a an obstacle is always better than ramming into it – especially when you a whole migration strategy is concerned.
Security vulnerabilities
Cybersecurity vulnerabilities are a serious threat when migrating healthcare legacy systems: sensitive and valuable patient data is a prime target for cybercriminals. Outdated software is often missing today’s security features, which can lead to breaches during operations. Moreover, migrating data from old to new systems can put it at risk since it may be made susceptible to unauthorized access, leaks, or even ransomware attacks. Legacy systems often do not have the infrastructure to be updated to new threats, our expert points out. These vulnerabilities, if not well-protected, put patient privacy at risk, which can lead to a whole lot of unwanted consequences.
To secure sensitive data, healthcare organizations should adopt a multi-layered data protection approach. Measures may include the encryption of data in transit, secure migration protocols, and restricting access whenever possible so that sensitive information is accessible only on a need-to-know basis. These can be done using regular security audits and penetration testing, which can identify and correct weaknesses in the new system, our expert points out.
Collaborating with seasoned cloud service providers or migration specialists further bolsters security. Alternatively, our experts are also licensed to run such security tests as to validate the integrity of the software. We use refined tools and knowledge to ensure data remains protected during the entire transition. This ensures that the migration is both secure and compliant when healthcare providers prioritise security.
Resistance to change
According to our expert, the main issue with legacy system migration lies with the resistance to change:
As healthcare staff feel daunted by the prospect of adapting to a new system during heritage system migration. Clinicians, administrators, and other users tend to use established workflows, leaving little room for deviation from what they know and may resist changes to that routine. This resistance may be because they do not understand the benefits of doing so, or they are afraid of the difficulty in adapting to the new system. Failing to address it can mean low adoption rates, less productivity, or even project failure.
The best strategy to overcome this inertia is clear communication paired with stakeholder engagement. This will give users a chance to understand the need for migration and the benefits of the new system. Comprehensive training sessions, user manuals, and constant support help staff gain confidence in using the new tools. Quick wins, such as increased efficiency or better functionality, also build excitement and foster adoption. Anew system into the context of other technologies they work with and bring them along in the process to ensure optimal use and successful integration of the new system.
Budget overruns
Unexpected technical challenges can often lead to delays or changes in scope, which in turn feed into budget overruns — a common pain point when migrating legacy systems in healthcare. A timeframe for developing and introducing a new system is usually over a year, but there are often delays, our expert says. The complexities of migrating data and integrating systems can quickly become a hidden cost.
Overlooked costs of training and vendor support (or post-migration maintenance) can also impact budgets. If not planned for properly, these overruns could threaten the success of the migration project and affect the overall financial health of the organization.
Hospital systems striving to stay within their migration budgets should begin by developing a detailed migration plan, including a thorough cost analysis. Those unexpected expenses in the job hunt can be buffered by a contingency budget. Regularly reviewing the project’s progress and expenses helps identify potential overruns early, allowing for timely adjustments. Yet, by maintaining strict financial oversight and planning for contingencies, organizations can stay within budget and ensure a successful migration, our expert assures.
Discover how we can help outsource Healthcare projects efficiently Speak to an expert today, and see how our on-demand IT talent and augmented teams can efficiently deliver value at every step of your roadmap.
Conclusion
Legacy system migration in healthcare is a complex but essential process for improving efficiency, security, and patient care. By addressing challenges like data integrity, regulatory compliance, and stakeholder resistance, organizations can ensure a smooth transition to modern systems.
Adopting best practices, such as careful planning, enhanced security measures, and stakeholder engagement, is key to achieving a successful migration. For expert guidance and tailored solutions, consider working with a trusted partner. A great option is to work with BGO Software, a company specializing in healthcare software development and system modernization.
Sources
Research Summary: 2024 Digital & IT Investment Trends[1]
Bojidar has over 12 years of experience developing digital health solutions and has a unique understanding of the industry. He is leading the entire team of software developers with great vision.
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