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Related Experiment Video

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TBase - an Integrated Electronic Health Record and Research Database for Kidney Transplant Recipients

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Transferable Migration Framework Derived from a Large-scale Tertiary Hospital EHR System.

Hojun Yu^1,2, Keehyuck Lee^3,4, Sangbeob Lee⁵

¹Office of Hospital Information, Seoul National University Hospital, Seoul, Korea.

Healthcare Informatics Research

|May 21, 2026

Summary

Migrating legacy electronic health record (EHR) systems to cloud-native platforms is essential. A phased roadmap using .NET 9 and RESTful APIs ensures system resilience and clinical data integrity during EHR modernization.

Keywords:

Cloud Computing Electronic Health Record Health Information Systems Software Design Systems Integration

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Last Updated: May 23, 2026

TBase - an Integrated Electronic Health Record and Research Database for Kidney Transplant Recipients

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Published on: April 13, 2021

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

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Published on: April 12, 2021

A Simple Migration/Invasion Workflow Using an Automated Live-cell Imager

A Simple Migration/Invasion Workflow Using an Automated Live-cell Imager

Published on: February 2, 2019

Area of Science:

Health Informatics
Software Engineering
Cloud Computing

Background:

Legacy on-premise Electronic Health Record (EHR) systems in tertiary hospitals face challenges.
Modernization to cloud-native platforms is a strategic necessity.

Purpose of the Study:

Establish an optimized roadmap for transitioning monolithic EHR systems to a microservice architecture-based cloud-native EHR (MCEHR).
Address technical and strategic challenges in EHR migration.

Main Methods:

Conducted a 3-month strategic assessment and case study for a global healthcare provider.
Utilized semi-structured interviews with clinical informatics officers and system architects.
Performed phased hybrid migration of over 20 TB of Oracle-based legacy data to .NET 9 and RESTful APIs.
Developed a proof-of-concept (PoC) to simulate high-concurrency clinical workloads and ensure system resilience.

Main Results:

Achieved 100% transaction integrity during the transition to .NET 9 and MCEHR across 1,012 clinical test cases.
Identified migration of embedded business logic in legacy Oracle views as a key bottleneck.
Validated stable throughput and reduced risk of clinical workflow delays with RESTful API services in the PoC.

Conclusions:

Transitioning to MCEHR is complex but strategically vital for modern healthcare.
A staged roadmap involving core technology upgrades (.NET 9, RESTful APIs), selective component migration, and DevOps adoption is proposed.
The roadmap aims to mitigate risks and ensure successful EHR system modernization.