The Systems Around the EHR Are the Next Migration Wave

The Systems That Never Made the Move 

Cloud adoption is not the problem for health systems. Many solved that years ago by moving email, collaboration platforms, HR systems, finance systems, and disaster recovery environments to the cloud. For most organizations, cloud infrastructure is already part of the operating model. 

What remains is a different challenge: deciding what to do with the systems that never made the move. 

For years, healthcare IT conversations revolved around the EHR. That is where the budget went, where executive attention went, and where technology teams focused their time and resources. Health systems spent the better part of a decade implementing, optimizing, integrating, and securing the EHR while building the infrastructure required to support it. 

Meanwhile, another layer of technology continued running quietly in the background. 

Forms platforms. Document workflows. Patient intake systems. Integration engines. Clinical content services. 

These systems support critical clinical and operational processes every day, yet many still run on infrastructure that predates the organization’s broader cloud strategy. 

Not because anyone deliberately decided they should remain on-premises. There simply wasn’t a compelling reason to move them. 

The EHR was the priority. Everything around it came second. And for a long time, that was a reasonable decision. The systems worked. The workflows held. Nobody had a strong reason to touch them. 

What Changed Wasn’t the Software 

The interesting thing is that the software itself has not changed all that much. The environment around it has. 

Over the last decade, healthcare organizations have had to contend with a growing list of challenges. Cybersecurity threats have increased and systems that aren’t patched and updated consistently can become a point of exposure. Infrastructure has aged. The expertise required to support legacy environments has become harder to find and harder to replace. At the same time, vendors have invested heavily in hosted deployment models, shifting innovation, security enhancements, and increasingly AI-driven capabilities into cloud environments. 

None of those changes, on their own, forced organizations to rethink their infrastructure strategy. Together, however, they have. 

As a result, healthcare IT leaders are asking a different question than they were asking five years ago. Not, “Does this system still work?” but rather, “Does it still make sense for us to own and manage the infrastructure supporting it?” 

That distinction matters. 

Most organizations are not evaluating these systems because they failed. They are reevaluating them because the economics and operational realities surrounding them have changed. The burden of maintaining aging infrastructure continues to grow while hosted deployment models continue to improve. 

The value equation looks very different from what it did a decade ago. 

Why EHR-Adjacent Software Is Becoming the Next Migration Wave 

That shift is creating a new wave of modernization conversations across healthcare. Not around the EHR itself, but around everything connected to it. 

The forms platforms that support patient intake. The document workflows that move information across departments. The integration engines that connect clinical systems. These are the systems that quietly power healthcare delivery every day, yet they often receive far less attention than the EHR itself. 

These systems may sit outside the EHR, but they are deeply embedded in the workflows surrounding it. They support clinicians and staff, exchange data continuously, and influence the patient experience in ways that are often overlooked. 

That is why this next migration wave looks different from the first one. 

Organizations are not simply moving infrastructure to the cloud because they can. They are reevaluating whether the operational burden of maintaining these systems on-premises still makes sense. 

As organizations begin evaluating these systems, many discover that the challenge is not moving the application itself but preserving the workflows, integrations, and dependencies surrounding it. Read: “Healthcare Cloud Migration Is More Predictable Than Most Organizations Think“ 

The systems surrounding the EHR may have been overlooked during healthcare’s first wave of cloud adoption. They are unlikely to be overlooked during the next one.  

Not because the software changed, but because the environment around it did. 

Related Resources 

• Healthcare Cloud Migration Is More Predictable Than Most Organizations Think 
• A Cloud-Smart Framework for Prioritizing Healthcare IT Migrations 

Download the Full Whitepaper 

The Off the Server White Paper picks up where this leaves off. It maps the four forces making on-premises infrastructure harder to justify, breaks down the three paths health systems are choosing between, and lays out how to sequence a migration so workflows, integrations, and dependencies survive the move.  

If your organization is evaluating the future of its FormFast environment, Interlace Health can help you assess your options and identify the path that best aligns with your operational and strategic goals.