Migrating charts is like delivering a history handle gently, or you lose the story.

Legacy data is messy and dear. It contains the old scar notes, the one nurse’s shorthand that matters, and the allergy a parent insisted on recording in the margins. Migrating that history is like midwifing a past into a new life: you must preserve the meaning, not only the bytes.

At a midwestern health system, a rushed migration stripped narrative fields down to CSVs. Post go live, clinicians lamented that lost context notes that had contained instructions about at-home caregiving were gone. Recovery cost weeks of reconciliation and immeasurable trust. We learned: data migration is not a back-end task; it is clinical stewardship.

Migration practices that honor stories

• Classify data by clinical value. Not all fields travel equally. Identify what must move verbatim (allergies, advanced directives) versus what can be summarized.
  
• Create a living archive. Keep an accessible snapshot of legacy views for a defined period and teach clinicians how to read them.
  
• Involve clinicians in mapping. Clinician review prevents translating nuance into noise.
  
• Automate quality checks, then spot-check with humans. Run reconciliation reports and have domain experts validate samples.
  

Migration checklist

• Inventory data sources and annotate clinical value.
  
• Run a dry-run migration and present clinicians with before/after stories.
  
• Build a reconciliation forum where clinicians can request targeted legacy recoveries.
  
• Preserve free text narratives as read-only archives for a defined phase post-go-live.
  

Data midwifery is about respect. When you carry a history forward with care, clinicians keep the thread of a life intact, and that continuity is medicine.