Cloud Migration for Medical Practices: A Practical Guide

“The cloud” has moved from buzzword to business necessity. But for medical practices, cloud migration comes with questions that don’t apply to typical businesses: Is it HIPAA compliant? Where does patient data actually live? What happens if the internet goes down?

These are legitimate concerns. But they’re also solvable. Thousands of medical practices have successfully moved to cloud services, reducing IT costs, improving reliability, and often enhancing security in the process.

Here’s a practical guide to cloud migration for medical practices—what to move, what to keep, and how to do it safely.

What “Cloud” Actually Means for Medical Practices

Let’s demystify the terminology:

Cloud Service Types

Software as a Service (SaaS): Applications accessed through a web browser. Someone else maintains the software; you just use it.

Examples: Cloud-based EHR, Office 365, cloud practice management
You manage: User accounts, data you put in
Provider manages: Application, infrastructure, updates, security

Infrastructure as a Service (IaaS): Virtual servers and storage in someone else’s data center. You manage the software; they manage the hardware.

Examples: Amazon Web Services, Microsoft Azure, Google Cloud
You manage: Operating systems, applications, data
Provider manages: Physical servers, networking, power, cooling

Platform as a Service (PaaS): Development and deployment platforms. Less relevant for most medical practices unless building custom applications.

What Practices Actually Use

Most medical practices don’t need to understand infrastructure details. They use SaaS applications:

Cloud EHR systems (eClinicalWorks, athenahealth, Practice Fusion)
Microsoft 365 (email, documents, collaboration)
Cloud phone systems (VoIP)
Cloud backup services
Cloud practice management systems

Moving to “the cloud” usually means adopting these services—not building your own cloud infrastructure.

Learn more about cloud solutions

What Should Move to the Cloud?

Not everything needs to migrate. Here’s how to prioritize:

Strong Candidates for Cloud

Email and productivity tools:

Microsoft 365 or Google Workspace
Benefits: Anywhere access, automatic updates, built-in collaboration
HIPAA note: Business Associate Agreement required and available

Backup and disaster recovery:

Cloud backup services
Benefits: Off-site protection, faster recovery, no tape management
HIPAA note: Encryption and BAA required

Phone systems:

Cloud VoIP replacing traditional phone lines
Benefits: Lower cost, more features, remote work support
HIPAA note: Choose HIPAA-compliant providers

Learn more about VoIP for medical practices

Practice management and scheduling:

Cloud PM systems or modules
Benefits: Patient portal integration, anywhere access
HIPAA note: Already common in healthcare, BAA required

File storage and sharing:

OneDrive, SharePoint, compliant file sharing
Benefits: Collaboration, version control, access anywhere
HIPAA note: Must be configured properly, BAA required

Already In the Cloud (Whether You Realize It)

Many practices are already using cloud services:

Web-based EHR? That’s cloud.
Online patient scheduling? Cloud.
Lab result interfaces? Often cloud-based.
Credit card processing? Cloud.

The question isn’t whether to use cloud—it’s how to use it strategically.

May Stay On-Premise

Some EHR systems:

Older or specialized systems without cloud versions
Systems with heavy customization
Note: Even on-premise EHR often has cloud backup options

Local file servers:

May make sense for some workflows
Often can be hybrid (local with cloud backup)

Specialized medical equipment:

Imaging systems with local storage
Diagnostic equipment with proprietary software
Note: These often need local connections regardless

Legacy applications:

Software that can’t be replaced or migrated
Custom applications without cloud versions

What Might Stay On-Premise

Some things are better left local—at least for now:

On-Premise Makes Sense When:

Network dependencies exist:

Equipment requiring local network connections
High-bandwidth local data transfer needs
Latency-sensitive applications

Internet reliability concerns:

Rural areas with unreliable connectivity
Practices where downtime is unacceptable
Note: Hybrid approaches can address this

Regulatory or contractual requirements:

Rare cases requiring on-premise data storage
Specific contracts mandating local control

Cost considerations:

Very small practices where cloud fees exceed local costs
Note: Do the full cost comparison, including hidden on-premise costs

Hybrid Approaches

Many practices end up with hybrid environments:

Cloud email and productivity
Cloud backup
Local EHR with cloud interfaces
Cloud phone system
Local specialized equipment

This is normal and often optimal.

HIPAA Compliance in the Cloud

The biggest cloud concern for healthcare: is it HIPAA compliant?

The Short Answer

Cloud services CAN be HIPAA compliant. Many are more secure than on-premise alternatives. But compliance requires proper selection and configuration.

Business Associate Agreements (BAAs)

Any cloud provider handling PHI must sign a BAA with your practice.

What a BAA establishes:

Provider’s HIPAA compliance obligations
How they’ll protect PHI
Breach notification requirements
Permitted uses of data
Termination and data return provisions

Major providers with BAAs available:

Microsoft (Microsoft 365, Azure)
Google (Google Workspace, Google Cloud)
Amazon (AWS)
Most healthcare-specific SaaS vendors

Red flag: If a provider won’t sign a BAA, don’t use them for PHI.

Security Requirements

HIPAA-compliant cloud services should provide:

Encryption:

Data encrypted in transit (TLS/SSL)
Data encrypted at rest
Encryption key management

Access controls:

Role-based access
Multi-factor authentication
Audit logging

Physical security:

Secure data centers
Access controls
Environmental protections

Administrative safeguards:

Security training for staff
Incident response procedures
Regular security assessments

Your Responsibilities

Having a HIPAA-compliant cloud provider doesn’t automatically make you compliant. You must:

Configure services properly: Default settings may not be secure
Manage access: Control who can access what
Train staff: Ensure proper use of cloud services
Monitor activity: Review audit logs for unusual access
Maintain BAAs: Keep documentation current
Conduct risk assessments: Include cloud services

Common Compliance Mistakes

Using consumer versions: Microsoft 365 Personal isn’t the same as Microsoft 365 Business with a BAA. Google personal accounts aren’t HIPAA-compliant. Use the right versions.

Ignoring configuration: OneDrive can be HIPAA-compliant, but not if files are shared publicly. Configuration matters.

Shadow IT: Staff using unauthorized cloud services (personal Dropbox, consumer file sharing) creates compliance gaps.

Missing BAAs: Using cloud services without BAAs in place, or letting BAAs expire.

Learn more about HIPAA compliance

Planning Your Migration

Step 1: Inventory Current State

Document what you have:

Current servers and their roles
Applications in use
Data storage locations
Network dependencies
Integration requirements

Step 2: Define Goals

Why are you migrating? Common goals:

Reduce IT maintenance burden
Improve reliability
Enable remote work
Reduce costs
Improve security
Support growth

Goals shape decisions about what to migrate and how.

Step 3: Evaluate Options

For each system or function, consider:

Cloud alternatives available?
BAA available from provider?
Integration with other systems?
Cost comparison (honest total cost)?
Migration complexity?
Staff training required?

Step 4: Prioritize and Sequence

Don’t migrate everything at once. Typical sequence:

Phase 1: Low-risk, high-impact

Email and productivity (Microsoft 365)
Cloud backup
Phone system (VoIP)

Phase 2: Practice operations

Practice management (if moving)
Scheduling systems
Patient communications

Phase 3: Clinical systems (if applicable)

EHR migration (major project, often separate)
Clinical integrations

Step 5: Plan Each Migration

For each system:

Timeline and milestones
Data migration approach
Integration testing
Staff training plan
Cutover strategy
Rollback plan

Step 6: Execute with Support

Have appropriate support:

Internal IT or managed IT provider
Vendor support for cloud applications
Training resources
Help desk for transition period

Common Migration Pitfalls

Underestimating Data Migration

Moving years of email, documents, and data takes time. Plan for:

Data cleanup before migration
Migration duration (often days or weeks)
Verification after migration
Historical data access during transition

Ignoring Integration Requirements

Systems that work together on-premise need to work together in the cloud:

Test integrations before cutover
Plan for integration gaps
Consider middleware if needed

Insufficient Training

New systems require new skills:

Train before cutover, not after
Provide reference materials
Have support available during transition
Expect productivity dip during learning curve

Internet Dependency Without Backup

Cloud requires internet. Plan for outages:

Backup internet connection (cellular, secondary ISP)
Offline capabilities where available
Downtime procedures for critical systems

Cost Surprises

Cloud costs are ongoing, not one-time:

Understand subscription vs. license models
Plan for growth (per-user pricing adds up)
Account for support and training costs
Don’t forget to cancel old services

Moving Too Fast (or Too Slow)

Too fast: Insufficient testing, training gaps, integration problems Too slow: Running parallel systems too long, staff confusion, doubled costs

Find the balance: thorough but efficient.

Migration Timeline Example

A typical email and productivity migration (Microsoft 365):

Week 1-2: Preparation

Inventory current email and files
Set up Microsoft 365 tenant
Configure security settings
Sign BAA
Create user accounts

Week 3-4: Pilot

Migrate small group (IT, volunteers)
Test functionality
Document issues and solutions
Refine training materials

Week 5-6: Migration

Migrate remaining users in groups
Run parallel access period
Monitor for issues
Provide support

Week 7-8: Optimization

Address remaining issues
Advanced training
Configure additional features
Document final configuration

Ongoing:

Decommission old systems
Monitor adoption
Continuous improvement

Working With Cloud Migration Partners

When to Get Help

Consider professional help if:

No internal IT expertise
Complex existing environment
Many integrations required
Large data volumes
Compliance concerns
Tight timelines

What to Look For

Healthcare experience:

Understands HIPAA requirements
Experience with medical practice systems
Familiar with healthcare workflows

Cloud expertise:

Certified in relevant platforms (Microsoft, etc.)
Migration experience
Security configuration knowledge

Support capabilities:

Training resources
Ongoing support options
Help desk during transition

Questions to Ask

Have you migrated medical practices before?
How do you handle HIPAA compliance?
What’s your migration methodology?
How do you handle training?
What support is available post-migration?
What does your pricing include?

Ready to Plan Your Cloud Migration?

At MedTech Consulting, we help medical practices move to the cloud safely and efficiently, with full attention to HIPAA compliance and minimal disruption to patient care.