Health and AI
EHR Migration in 2026: Why Clinicians Fear It and How to Succeed
EHR migration: why clinicians dread switching EHR, what real hospital go-lives teach, big bang vs phased rollout, training and change management that work.
Summary
The essentials in 30 seconds
| Question | Short answer | Key takeaway |
|---|---|---|
| Why do clinicians dread switching EHR? | Because they have seen go-lives go wrong: double data entry, lost letters, a ward slowed down for months. | The fear is grounded in facts, not in rejecting the tool. |
| Can an EHR migration really fail? | Yes. One French general hospital shut down the medical record module of its new EHR 48 hours after go-live, then lived through four years of double data entry. | Failure comes from organisation, rarely from a missing feature. |
| What do clinicians lose in the switch? | Years of customisation: letter templates, shortcuts, ward habits. | Announcing this loss before go-live defuses the disappointment. |
| Big bang or phased rollout? | Both exist. Big bang concentrates the workload into a few weeks; a phased rollout spreads it out but creates a period where two systems coexist. | The choice depends on the size and maturity of the hospital. |
| How long does the hard period last? | A few weeks for everyday use, several months for full confidence. | The project does not end on go-live day. |
| Who needs to be involved? | Nurses, doctors, and medical secretaries, who are often forgotten. | A profession left out of the working groups will be the first to disengage. |
| What reassures a team the most? | Internal super-users trained early, a vendor present on site and fast fixes. | Responsiveness in the first weeks matters more than the list of modules. |
Introduction
An EHR migration is one of the most feared projects in a hospital. The electronic health record (EHR) is the software in which the hospital documents a patient’s entire care: history, prescriptions, clinical notes, reports. Announce an EHR change on a hospital ward, and the first reaction will rarely be enthusiasm. Clinicians have long memories: many have lived through a go-live that disrupted their work for months. Their concern is not resistance to digital tools, it is a clear-eyed reading of what can go wrong.
This fear is based on real cases, told publicly by hospital leadership teams at the SantExpo agoras (France’s main healthcare trade show): a medical record shut down two days after go-live, four years of double data entry, thousands of calls to the support desk in the first week. These lessons learned are valuable because they say what vendor brochures leave out.
At Galeon, an EHR built with clinicians since 2016 and deployed in 19 hospitals, we hear the same concern at every new project. This article goes through the most common objections and how to answer them concretely, based on what teams have actually lived through.
A successful EHR switch is not measured on go-live day, but by what the ward can do three months later.
Why do clinicians fear switching EHR in a hospital?
Because the EHR is their main working tool, and a failed go-live is paid for in hours lost at the patient’s bedside. The fear comes from experiences they lived or heard about, not from refusing change.
An electronic health record carries years of adjustments: report templates, standard letters, validation workflows specific to each department. When it is replaced, all that customisation disappears at once. For a midwife on call or an emergency physician, it means finding their bearings again at the very moment the ward has to keep running.
Clinicians also dread the period when the old and new tools coexist. Two applications open at the same time, information entered twice, a rising risk of error: that is the scenario everyone wants to avoid.
Can an EHR migration fail?
Yes, and some hospitals have said so in public. Their candour is the best source for understanding what makes a project fail.
At SantExpo 2024, the leadership of a general hospital in Haute-Savoie described its story: a new EHR launched in March 2018, a nursing record and an operating theatre module that held up, but a medical record shut down 48 hours later. The hospital had to go back to the old software for reports and live through four years of double data entry, described as “a catastrophe” for professionals (SantExpo 2024 agora).
The causes acknowledged by the hospital are instructive: medical document tools (letters, reports) less rich than those of the old system, and medical secretaries missing from the working groups even though they are central to how the EHR is used. None of these causes is a missing feature in the strict sense: they are organisational issues.
What hospitals that went big bang say
A regional hospital group (GHT) in Brittany switched all its hospitals over in January 2026. Before go-live, its leadership announced there would be a “regression”: the loss of customisation, not of any feature (SantExpo 2025 agora). After the switch, the support desk received 4,500 calls in one week, around 60% of them from doctors, who had completed only 10 to 15% of the e-learning, compared with 100% for nursing and allied health staff (SantExpo 2026 agora).
What do clinicians really lose when switching EHR?
Mostly they lose customisation: the templates, shortcuts and habits built around the old tool. In return they gain more structured, shared data, but that gain arrives later than the loss.
One hospital described its former EHR, used for 17 years and configured doctor by doctor, as “a big typewriter”: much appreciated, but impossible to extract any data from (SantExpo 2026). Replacing this kind of tool means trading individual comfort for information the whole team can use.
Saying this clearly from the outset changes how the project is received. A team warned that it will lose its personal templates, and that knows when they will be rebuilt, experiences the first week as a stage. A team promised a “ready to use” tool experiences it as a betrayal.
Should an EHR go-live be big bang or phased?
Both approaches work, as long as you accept their trade-offs. Big bang avoids double data entry but concentrates the whole workload into a few weeks; a phased rollout spreads the effort but imposes a period where two systems coexist.
In the maternity units where Galeon is deployed, teams have often chosen to bring every area of the maternity unit on board at once, so that the transition is as short as possible. A head of a maternity department sums it up: the aim is “for people to get to grips with the tool quickly” rather than running two applications side by side. Conversely, a large private hospital planned its rollout over one year, with a pilot department, because you “can’t just flip a switch” on an entire hospital.
The right choice therefore depends on scope. A self-contained department such as a maternity unit copes well with a single switch-over; a whole hospital, with emergency department, operating theatres, pharmacy and outpatient clinics, benefits from moving forward in batches.
How long does the hard period last after EHR go-live?
A few weeks for everyday use, several months for full confidence. The most honest hospitals even talk about years before everyone is completely at ease.
In a cancer centre, an EHR hotline staffed by clinical super-users stayed in place for nearly two years (lessons learned from a French comprehensive cancer centre). Two and a half years after go-live, the centre admits that “we can’t say we’ve brought everyone on board”.
A coordinating midwife in a maternity unit equipped with Galeon puts it her own way: she needs “2, 3, 4 years” to be truly at ease with a work application, and “not everyone realises that”. Building this time into the schedule avoids judging a project on its first three weeks.
How do you manage change with clinical teams during an EHR migration?
Change management in a hospital starts with people: every profession that touches the record has to be involved, especially the ones that get forgotten: medical secretaries, healthcare assistants, pharmacy. A profession left out of the preparation will be the first to disengage.
Field feedback converges on three levers. First, internal super-users (a nurse manager, a midwife, a doctor) who dive into the tool before everyone else and relay requests. Second, clinical leadership of the project rather than IT leadership: the CIO of a regional hospital group in south-west France says that with Galeon, for the first time, “the clinical side had the lead on the project”. Third, EHR training on real cases from the department rather than generic demonstrations.
One head of department also recommends sending test logins to teams before training, so they can “poke around” at their own pace. Half a day of training is then enough for most clinicians to get started.
Traditional EHR switch or one built with clinicians: what changes?
| Criterion | Traditional approach | Galeon approach |
|---|---|---|
| Project leadership | Often led by IT, clinicians are consulted | Led by clinicians, with nursing super-users |
| Announcing what will be lost | Rarely made explicit before go-live | Discussed upfront, with a schedule for rebuilding templates |
| Training | Generic sessions or e-learning | Half a day on the department’s own clinical cases |
| Vendor presence | Varies with the contract | Team on site during go-live |
| Adjustments after go-live | Scheduled in the vendor’s roadmap | Raised at staff meetings and fixed as they come |
| Medical secretaries | Often involved late | To be involved from the preparation phase (a point of caution with every vendor) |
| Migrating existing records | Separate technical project | Organised with the department, record by record if needed |
| Follow-up after go-live | General IT support | Dedicated follow-up meetings and improvement platform |
Limits and points of caution
- No vendor avoids every friction. Even with a team on site, the first weeks bring prescriptions that do not print as expected or duplicate records to fix.
- Configuration takes time. Teams often expect all their letters and templates on day one; part of them is built during the rollout.
- Interfaces with the rest of the hospital information system (patient identity, laboratory, imaging) remain the most delicate part, whichever EHR is chosen.
- Training doctors is harder to achieve than training nursing and allied health staff; specific support has to be planned.
- A whole hospital is not a maternity unit. The experience of a self-contained department does not transfer as is to a multi-site organisation.
FAQ
How long does it take to switch EHR in a hospital?
For a department such as a maternity unit, preparation takes a few months and go-live a few days. For a whole hospital, organisations tend to talk about a year of phased rollout, followed by a stabilisation period.
Can double data entry be avoided completely?
Not always, but it can be limited to a few days by switching a department over in one go and migrating ongoing records before go-live.
What is an electronic health record (EHR)?
It is the software that brings together a patient’s entire care in hospital: history, prescriptions, nursing care, reports and results. It replaces the paper record and is shared between the professionals caring for the patient.
Should everyone be trained before go-live?
Yes, and on real cases. A few hours of training is enough to get started; confidence then comes with use and support.
What should be done with the old EHR’s letter templates?
List them before go-live, prioritise the ones used every day and announce a schedule for the others.
Who should lead change management in an EHR project?
A clinical pair (head of department and nurse manager) backed by the IT department. Projects led by IT alone lose traction on the ground more often.
How do you know the go-live succeeded?
Look three months later: does the department run without the old tool, are adjustment requests being handled, do clinicians find information faster than before?
In summary
Clinicians’ fear of switching EHR rests on very real failures, told in public by hospitals: a medical record shut down two days after go-live, years of double data entry, thousands of calls to support. These failures rarely come down to a missing feature and almost always to organisation: losses not announced, professions forgotten, support that stops too early. Answering this objection means acknowledging what the team will lose, handing leadership to clinicians, training on real cases and staying present after go-live. It is the method Galeon has applied with clinical teams since 2016.
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Sources
- SantExpo 2024: lessons learned from an EHR switch in a general hospital in Haute-Savoie
- SantExpo 2025: a big bang EHR rollout in a regional hospital group (GHT)
- SantExpo 2026: the clinical realities of an EHR deployed at GHBA
- EHR challenges in a cancer centre: clinical hotline and support
- The French Ségur digital health programme, French Digital Health Agency (ANS)
- Galeon: hospital interoperability in 2026
- Galeon: Ségur digital health wave 2, what hospitals need to do
