Who this is for:
- You’re in the middle of an electronic health record (EHR) implementation, and go-live is approaching
- You’re coordinating a transition, and you want the practice fully prepared before switch day
- Your group signed with a new EHR vendor, and you’re planning everything that needs to happen between now and go-live
In this article:
- Review your conversion timelines and make sure your team understands them
- Confirm your old vendor’s extraction process and costs
- Plan legacy system access for after go-live
- Brief your billing team on the wind-down
- Inventory your third-party connections
- Flag any non-standard data early
- Review your network and infrastructure
If you’re getting ready to switch to a new EHR system, you’ve probably got a detailed EHR implementation plan from your vendor. They’re handling the training, the system configuration, and the technical setup to get your team ready for go-live, the day you officially switch from your old system to the new one.
But there’s a separate set of things that need to be in place before that day, and most of them aren’t part of the vendor’s plan. They’re on the data conversion side, and they’re the things that tend to surface as surprises during or after the switch because nobody flagged them for you ahead of time.
We’ve done more than 2,000 data conversions across over 100 EHR systems, and we’ve never missed a go-live. Across all of those transitions, the same gaps come up over and over: the extraction timeline with the old vendor wasn’t confirmed, the billing team wasn’t briefed on the wind-down, legacy access wasn’t planned, and the third-party connections that won’t carry over weren’t inventoried.
These aren’t things you’d know to ask about unless you’ve been through this before, and they’re not things your EHR vendor is responsible for raising.
This checklist is built from what we’ve learned to look for. Every item here is something that, when it’s confirmed before go-live, makes the transition smoother for you, your team, and everyone coordinating the implementation.
Review your conversion timelines, make sure your team understands them
Your data doesn’t all move at the same time, and the data conversion timeline runs alongside the implementation, not inside it.
Demographic conversions need at least six weeks before go-live. Appointments need at least eight weeks. Those two start well before switch day. But your clinical data, your chart documents, visit notes, and full patient record don’t convert until after you’re live on the new system. Your providers’ documents in the old system, right up until go-live day.
Once those charts are signed off and closed out, your old vendor extracts a complete snapshot, and the conversion team works from that. That clinical data conversion takes another six to eight weeks from the time the data is received.
What this means in practice: your conversion partner needs to start working weeks before go-live, and the clinical piece will still be running well after. If your conversion partner needs eight weeks for appointments and you’re six weeks out, that’s a conversation that needs to happen now.
Make sure the people managing the day-to-day of your transition, not just leadership, understand the full timeline, not just the go-live date.
Confirm your old vendor’s extraction process and costs
Not every conversion starts with the conversion partner pulling the data directly. Sometimes the old vendor has to extract it, and that process comes with its own timeline and sometimes its own cost.
If your current system is server-based, older, or no longer actively supported, expect the extraction to take longer and require more coordination. Some vendors are straightforward.
Others are slow, unresponsive, or charge an extraction fee you didn’t budget for. That extraction fee conversation isn’t always easy, but having it now is far better than discovering it mid-implementation when it can push your go-live date.
Confirm with your old vendor as early as possible: what’s the process for releasing your data, how long will it take, and is there a cost? Get this in writing so it doesn’t become a bottleneck when the timeline tightens.
Plan legacy system access for after go-live
You’re going to need your old system after you switch. Your clinical data is still converting in the background after go-live, which means your providers will need to look up historical chart notes in the old system during that window. Your billing team is running a wind-down in the old system at the same time.
We recommend maintaining either read-only access or downgraded licenses on your legacy system for about 90 to 120 days after going live. Some vendors require advance notice to set this up. Some charge for it. If your old vendor deactivates your accounts the day you leave, you’ve lost your safety net during the most critical part of the transition.
Confirm this with your old vendor before go-live: can you keep access, in what form, for how long, and at what cost?
Brief your billing team on the wind-down
This is the one that gets missed most often, and it creates the most operational stress when it does.
Your financial data doesn’t transfer between EHR systems. This is industrywide. The claims you’ve already submitted in your current system stay there. They’re tied to your existing clearinghouse, and the revenue cycle is already in motion.
Once you’re live on your new system, you bill new visits from there. But everything already in the pipeline stays in the old system, and you work it down over time.
That wind-down typically runs the same 90-to-120-day window as your legacy access. During that stretch, your billing team is working in two systems. They need to understand which claims go where and have a plan for managing both platforms through the transition.
Your billing team may not have been involved in the EHR evaluation or the implementation planning at all. The first time they hear about the wind-down shouldn’t be go-live day. Bring them into the conversation now. Walk them through the timeline, the dual-system period, and when they can expect to fully transition.
If your CFO or billing lead tracks revenue cycle performance, they also need to know that reporting will be split across two platforms during this period.
Inventory your third-party connections
If you have data feeds from outside sources wired into your current system, those connections don’t automatically follow you to the new one. Lab integrations, clearinghouse connections, insurance carrier data feeds: anything running in the background that your workflows depend on.
Sometimes you have a data feed that’s been running for years and you don’t really know how it works, but it’s already set up in your system. When you switch, that connection breaks, and nobody may realize it until the data stops flowing and something downstream is affected.
Go through your current system and identify every third-party connection. For each one, figure out whether it needs to be rebuilt, reconnected, or replaced in the new environment. Your conversion partner can build interfaces to bridge those gaps, but they need to know about them. The earlier these get identified, the more time there is to plan and scope the work.
Flag any non-standard data early
Standard conversions cover three categories: demographics, appointments, and clinical data. If you rely on information that doesn’t fit neatly into those three, like custom reports, document templates, or data that lives outside the normal chart structure, it needs to be surfaced before go-live.
There’s an option called a document build: if the conversion team can run a report on the information and tie it to a patient, they can create a PDF version and place it under the patient’s attachment section in your new EHR. It’s not the same as a native conversion, but it gets the information into a format your providers can access from one place.
Non-standard work adds scope and time to the project. The sooner the conversion team knows about it, the sooner they can tell you what’s possible, what it costs, and how it fits into the timeline. Flagging it after go-live means it either gets rushed or it doesn’t get done.
Review your network and infrastructure
Your EHR vendor handles the software. They don’t handle your network, your hardware, or your security settings. If you’re switching systems, there may be infrastructure changes needed to support the new platform, especially if you’re moving from a server-based system to a cloud-based one or adding locations during the transition.
These questions tend to surface after go-live when something doesn’t work the way you expected. Having someone review your network and infrastructure against what the new system requires before go-live means you’re planning ahead rather than troubleshooting under pressure. If you don’t have internal IT resources for this, it’s a conversation worth having with your technology partner before switch day.
Checklist summary
Here’s everything in one place. This is the summary version of the checklist above.
Conversion timeline:
- Confirm demographic conversion timeline (at least 6 weeks before go-live)
- Confirm appointment conversion timeline (at least 8 weeks before go-live)
- Confirm clinical conversion timing: happens after go-live, takes 6-8 weeks to complete
- Confirm your team understands how the conversion timeline overlaps with the implementation schedule
Old vendor coordination:
- Confirm extraction process with old vendor (how it works, how long it takes)
- Confirm extraction fee if applicable (how much, when it’s due)
- Confirm legacy system access for 90-120 days post-go-live (read-only or downgraded licenses)
- Confirm legacy access cost and process with old vendor
Billing:
- Brief billing team on the wind-down (dual-system period, timeline, which claims go where)
- Brief CFO or billing lead that reporting will be split across two platforms during the wind-down
Third-party connections:
- Inventory all data feeds, lab integrations, and clearinghouse connections
- Determine plan for each connection: rebuild, reconnect, or replace in new environment
Non-standard data:
- Flag any data outside demographics, appointments, and clinical with conversion team
- Scope document builds if needed
Infrastructure:
- Review network, devices, and bandwidth against new system requirements
- Confirm security settings for the new platform
Where Focus comes in
When your EHR partner brings us in for the conversion, you get a team that walks through every item on this list with you. We cover conversion types, timing, pricing, and expectations on the first call, so you’re not finding out about the billing wind-down or the clinical conversion timing on go-live day.
You also get a team that flags the things that don’t always come up in the implementation plan. When non-standard data or third-party connections surface, we can scope the custom work and build the interfaces to keep your workflows connected.
When the extraction from your old vendor needs coordination, we’ve been through the process with over 100 different EHR systems, and we know what to expect.
We’ve never missed a go-live. That’s not because the data is always simple. It’s because we’ve learned, across thousands of transitions, that the practices that have this list confirmed before switch day are the ones that have smooth transitions.
As your Unified Partner, we handle IT, security, and data together. If the infrastructure review on this checklist is something your practice doesn’t have internal resources for, that’s something we help practices with every day.
Frequently asked questions
What should be in place before an EHR go-live beyond the vendor’s checklist?
Your conversion timelines should be confirmed and coordinated with the implementation schedule. Your old vendor’s extraction process and costs should be understood. Legacy system access should be planned. Your billing team should be briefed on the wind-down.
Third-party connections should be inventoried. Non-standard data should be flagged. And your network infrastructure should be reviewed against what the new system requires.
Why does my billing team need to know about the wind-down before go-live?
Your financial data doesn’t transfer between EHR systems. After go-live, your billing team works in two systems for several months: billing new visits in the new system while working down the existing pipeline in the old one. If they don’t know this is coming, go-live day is when they find out, and that’s too late to plan.
What’s an extraction fee?
If your old EHR vendor controls access to your data and has to extract it for the conversion, they may charge a fee. The amount varies by vendor. It’s a cost that comes from your old vendor, not your conversion partner, and it’s worth confirming early so it doesn’t surprise your budget or delay the timeline.
What happens to third-party data feeds when I switch EHRs?
Connections wired into your old system, like lab integrations, clearinghouse connections, or insurance carrier data feeds, don’t automatically follow you to the new one. They need to be inventoried before go-live and rebuilt or reconnected in the new environment.
Your conversion partner may be able to build interfaces to bridge those gaps, but they need to know about them early.
Who handles the network and infrastructure when switching EHRs?
Your EHR vendor handles the software. The network, hardware, security, and infrastructure underneath it are your practice’s responsibility. If you don’t have internal IT resources to review this before go-live, a technology partner can help assess what needs to change to support the new system.
