“Just migrate everything” is one of the most expensive sentences you can say at a data migration kickoff. It sounds safe, since nobody gets blamed for keeping history. A published case from Geisinger shows why it often isn’t the right call.

When Holy Spirit Hospital joined Geisinger in 2014, its legacy inpatient system held roughly 750,000 records. Many were more than ten years old, about 50,000 belonged to patients who had died, and many held no inpatient data at all. Geisinger chose not to convert historical notes. Teams carried over what clinicians needed to treat patients (active medications, allergies, and orders) and kept the old system available read-only. About 33 months later, access logs showed a single clinician had logged in over the previous six months.

A second case in the same paper took the opposite approach. Reliant Medical Group converted 15 years of history or more electronically. Their finding: cost tracked the number of different data types converted far more than the number of years.

So the real question is which data, and for whom. In practice, that usually breaks into three decisions:

  • Migrate what the business runs on today.
  • Archive older history somewhere searchable and read-only.
  • Retain what legal, tax, and audit rules require.

The cutoff is a business decision, not an IT default, and it can differ by function. Make it early, with the people who will use the data and with legal in the room.

How much history did your last migration carry over, and would you make the same call again?

Source: Schreiber R, Garber L. “Data Migration: A Thorny Issue in Electronic Health Record Transitions.” ACI Open, 2020.

Originally posted on LinkedIn.