A Cloud-Smart Framework for Prioritizing Healthcare IT Migrations

Cloud Adoption Is No Longer the Challenge 

For most healthcare organizations, the hard part of cloud migration is no longer getting to the cloud. 

Email, collaboration platforms, finance systems, and disaster recovery made that move years ago. Cloud infrastructure is now a routine part of healthcare IT operations. 

The harder question is what should move next, and in what order. 

That question is becoming more pressing as health systems begin evaluating the operational software surrounding the EHR. EHR vendors often call these third-party applications, a label that understates how embedded they actually are. This layer of EHR-adjacent software, including forms platforms, integration engines, document workflows, patient intake systems, and communication tools, is now entering modernization conversations.  

The challenge is that these systems are not all equal. 

Some create significant operational burden. Some are deeply integrated into clinical workflows. Some are relatively straightforward to modernize. Others require careful planning and coordination. 

Treating them all the same is often where organizations get into trouble. 

Why Cloud-First Is Giving Way to Cloud-Smart 

That reality is helping drive a broader shift across healthcare IT from cloud-first to cloud-smart. 

Healthcare organizations have already experienced the downside of treating cloud migration as a one-size-fits-all exercise. Many discovered that moving a workload does not automatically reduce complexity. In some cases, it simply relocates it. 

In fact, healthcare organizations are more likely than those in any other industry to move workloads back on-premises after migrating them.¹

As a result, organizations are becoming more deliberate about where and how they modernize. They are evaluating systems based on operational fit, business value, security requirements, and long-term maintainability rather than migrating simply because a hosted option exists. 

The question is no longer, “Can this move to the cloud?” 

The question is, “Should it move now, and what value does that create?” 

1. HealthTech Magazine, “Cloud vs. On-Prem: Healthcare Organizations Can Find Key Solutions for Their Workloads” (January 2025)

Why Many Organizations Start with Resiliency 

For many organizations, resiliency is not the first place they expected to start. 

Yet backup and disaster recovery often provide a logical entry point because they improve recovery readiness immediately without requiring major workflow changes. 

Organizations gain value regardless of where they ultimately land on their broader modernization journey. 

From there, prioritization becomes less about technology and more about operational realities. 

Not All Systems Create the Same Migration Challenge 

Some systems consume disproportionate amounts of IT time and resources. They run on aging infrastructure and require ongoing maintenance, manual upgrades, and specialized expertise that becomes harder to find every year. 

Others create very little operational burden despite remaining on-premises. 

At the same time, some applications maintain relatively contained integration footprints. Others sit at the center of multiple clinical and operational workflows, touching the EHR, authentication systems, repositories, and downstream applications. 

Both factors matter. 

A system that creates significant operational burden but maintains limited workflow dependencies may represent a strong modernization candidate. A deeply integrated platform supporting multiple clinical processes may require a more deliberate timeline. 

Understanding those workflow dependencies is often where organizations uncover the greatest migration complexity.

The point is not that every organization should follow the same sequence. 

The point is that every organization should have a sequence, and mapping that sequence is far easier with a partner who has navigated these dependencies before and knows where the complexity tends to hide.  

Start with Priorities, Not Applications 

The most successful cloud migrations rarely begin with a list of applications. They begin with a clear understanding of operational priorities. 

• What risks need to be reduced? 
• What burden needs to be removed? 
• What capabilities need to be added? 
• What constraints exist today that will become more difficult to manage tomorrow? 

Those questions often produce better decisions than simply asking which applications are easiest to move. 

Healthcare organizations spent the last decade moving infrastructure to the cloud. The next decade will be defined by how thoughtfully they modernize the operational systems that remain. 

The organizations making the most progress are not trying to move everything at once. They are identifying where modernization creates the greatest operational value and building a roadmap from there. 

Once organizations understand what should move first, the next question becomes how they want to manage those systems going forward.

Related Resources 

• Healthcare Cloud Migration Is More Predictable Than Most Organizations Think
• Three Paths to the Cloud: How Health Systems Are Approaching EHR-Adjacent Software Today 

Download the Whitepaper 

This blog covered how to think about sequencing. Our whitepaper, Off the Server, goes the rest of the way: a full cloud-smart approach to prioritizing EHR-adjacent systems, the three paths health systems weigh for managing them, and the operational and cost factors that determine which moves make sense and when. 

If your organization is evaluating the future of its FormFast environment, contact Interlace Health to discuss the path that best fits your operational and strategic goals.