ArticleHealthcare informatics research2026
Transferable Migration Framework Derived from a Large-scale Tertiary Hospital EHR System.
Article in Healthcare informatics research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
4 authors.
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Abstract
objectivesMigrating legacy on-premise electronic health record (EHR) systems in tertiary hospitals to modern cloud-native platforms presents technical and strategic challenges. We aimed to establish an optimized roadmap for transitioning legacy monolithic systems to a microservice architecture-based cloud-native EHR (MCEHR).
methodsWe conducted a 3-month strategic assessment and case study based on the modernization requirements of a global healthcare provider. The methodology incorporated semi-structured interviews with key stakeholders, including clinical informatics officers and system architects, to identify critical pain points such as .NET 4.0 end-of-support risks and performance bottlenecks during peak clinical hours. Phased hybrid migration was adopted, analyzing over 20 TB of Oracle-based legacy data and evaluating the technical feasibility of transitioning to .NET 9 and RESTful APIs. To ensure clinical safety, a proof-of-concept (PoC) environment was developed to simulate high-concurrency clinical workloads, emphasizing system resilience and transaction integrity during intensive order-entry periods.
resultsThe transition to .NET 9 and MCEHR demonstrated 100% transaction integrity across 1,012 complex clinical test cases. Frontend and backend modernization showed high feasibility; however, migration of business logic embedded within legacy Oracle views represented a primary technical bottleneck, necessitating targeted decoupling. The PoC confirmed that RESTful API-based services maintained stable throughput under heavy concurrent loads, significantly reducing the risk of system-induced delays in clinical workflows.
conclusionsTransitioning to an MCEHR architecture is complex but strategically essential. The proposed task force team roadmap outlines staged upgrades incorporating core technology modernization (.NET 9 and RESTful APIs), selective business component migration, and parallel DevOps adoption.
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