The world is moving at a fast pace and placing first-line industries like healthcare under great stress to innovate their approaches and processes. However, a lot of healthcare organizations still find it hard to conduct healthcare software modernization and continue working on old legacy systems that lead to operational inefficiencies such as slow data access and major security threats.
From the business perspective, the price of a possible mistake is quite high. According to the IBM Security Cost of a Data Breach Report, the average healthcare data breach, which an outdated legacy system may cause, now costs $10.93 million. These breaches result in financial losses, trigger severe regulatory penalties, and destroy patient trust.
But it’s not only about money. Legacy systems directly impact the dynamics of patient care. Outdated infrastructure increases the risk of medical errors and leads to poor treatment
outcomes. Any organization that wants to maintain trust within the healthcare field should prioritize healthcare digital transformation as a foundation for demonstrating high-quality services.
But where to start?
My name is Anastasiia Kazakova. I’m a Project Manager and Associate Delivery Manager at Uptech. Given my expertise, I’ll outline key aspects of healthcare software modernization to help you navigate this process and implement updates in your organization.
Keep reading to learn more about legacy systems in healthcare.
What is a Legacy System in Healthcare?
I think before going into practical tips and tricks of healthcare software development, it’s important to know the underlying theoretical principles. So first, let's define what legacy systems are.
Legacy systems are old infrastructures, software, or applications that do not meet modern industry standards anymore.
Legacy systems are a common occurrence in healthcare due to the industry’s historical lack of agility and strict regulatory requirements. Many legacy systems are still running on old programming languages like COBOL or MUMPS, making it very difficult to modernize and integrate with new technology.
Legacy systems in healthcare:
- Are typically hosted on old physical servers
- Have physical backups and non-reliable recovery processes
- Have non-standard data structures that limit interoperability
- Have non-intuitive designs that require extensive training
- Come with knowledge silos, which means that system expertise is concentrated in few long-term employees
- Provide limited analytics and business intelligence capabilities
Types of legacy healthcare IT systems
Okay, now let’s move to specific types of legacy healthcare systems.
If you work in healthcare, you’ve likely encountered some of these — and maybe more than a few. These are the old workhorses of the industry, the systems that have been here forever and are somehow still going. But the truth is, they’re also the ones slowing things down and making innovation feel like an uphill battle. They’re deeply integrated into organization workflows, so replacing them seems troublesome.
The trick is to be strategic about it. Identify the systems causing the most pain, then prioritize modernization based on impact and feasibility.
Let’s break it down and get a clear picture of the main types of legacy systems in healthcare.
Electronic health record (EHR) systems
Electronic health record systems are digital versions of patient charts. They hold electronic health records: everything from medical history to test results. The problem? Many of these legacy EHRs were built on old programming languages (MUMPS or COBOL, for example). They’re difficult to use, and they don’t integrate well with newer systems. If your staff spends more time battling the system than caring for patients, you’ve got a legacy EHR on your hands.
Possible challenges: Slow performance, high-cost maintenance, outdated user interfaces, and poor interoperability.
Remote patient monitoring (RPM) systems
RPMs help healthcare providers monitor the blood pressure, glucose levels, heart rate, and oxygen saturation of their patients. They are life-changing when it comes to managing chronic conditions or post-op care.
But here’s the thing: Legacy RPM systems have limits. They may be sufficient for the purpose and get the job done, but they don’t do it efficiently or securely.
Possible challenges: Limited device compatibility, poor real-time data synchronization, and security vulnerabilities.
Laboratory information management systems (LIMS)
LIS handles lab workflows, such as test orders, sample tracking, and results reporting. Legacy versions are infamous for using multiple data formats that turn integration with other systems into a challenge. It’s time to take a hard look at your LIS if your lab is still faxing results or can’t share data with your EHR.
Possible challenges: Cloud support, mobile accessibility, and integration with EHR systems.
Picture archiving and communication systems (PACS)
PACS are systems that store, retrieve, manage, and distribute medical images such as X-rays, MRIs, CT scans, and ultrasounds. They serve as the backbone of radiology departments, enabling medical professionals to access and share images digitally instead of physical copies.
However, older PACS platforms don’t always integrate with modern EHRs or RIS, causing inefficient workflows and repeated manual input.
Possible challenges: Large file management, slow image retrieval, and poor compatibility with AI-powered diagnostics.
Radiology information systems (RIS)
Radiology information systems manage imaging workflows like scheduling, tracking, and reporting. Older RIS systems can’t keep pace with advancing imaging technologies (such as 3D imaging) and face difficulties integrating with newer PACS or EHRs. If your radiologists are still working with clunky interfaces or manual processes within the RIS, your system is likely overdue for an update.
Possible challenges: Poor integration with PACS, EHRs, and cloud storage.
Patient engagement systems (PES)
PES are used for patient registration and scheduling. Legacy systems don’t usually provide options for self-service (such as online scheduling) and can struggle to integrate with current patient portals. Is your front desk still drowning in paperwork? Your patient management system may be the part of the problem.
Possible challenges: UX accessibility and poor integration capabilities.
Hospital information systems (HIS)
HIS systems are the big, all-in-one platforms that run clinical, administrative, and financial operations across a hospital. The legacy versions are monolithic, inflexible, and difficult to update.
Possible challenges: Outdated databases and the need for excessive manual input.
Clinical decision support systems (CDSS)
CDSS provides evidence-based recommendations for clinicians to support medical decision-making. The older ones? They’re rule-based, sometimes inflexible, and often outdated. If your clinicians are simply ignoring the system because the recommendations feel irrelevant or out of date, your CDSS needs a makeover.
Possible challenges: Outdated medical knowledge bases and poor integration with EHRs.
Real-world healthcare software modernization use cases
We can talk a lot about the benefits of modernizing old systems, but practical cases are always the best way to prove that it really makes sense. Nowadays, modern technologies provide an opportunity to experiment, look for new approaches, and optimize processes to grow a business and increase its success, along with profits. And most importantly, make the life of their patients easier.
Here are two recent cases that are worth your attention.
Patient flow optimization with TeleTracking
Challenge: The Maidstone and Tunbridge Wells NHS Trust faced inefficiencies in bed management, leading to delays in patient care and increased costs.
Solution: They implemented TeleTracking’s cloud-based software for real-time bed tracking and patient flow management.
Outcomes:
- The Maidstone and Tunbridge Wells NHS Trust saved an estimated £2.1 million annually.
- Improved care standards by reducing delays and optimizing bed usage.
- Improves staff productivity and patient satisfaction.
Multi-payer portal implementation at Johns Hopkins Health Plans
Challenge: Johns Hopkins Health Plans, a health plan provider, experienced inefficiencies in its administrative processes as it had separate systems for claims, eligibility, and prior authorizations. Providers struggled with multiple payer portals that delayed patient care and added needless administrative burdens and frustration.
Solution: They collaborated with HealthEdge to deploy a multi-payer portal, an integrated platform that consolidates administrative functions like claims submission, eligibility checks, and prior authorizations into one easy-to-use interface.
Outcomes:
- Users gained access to comprehensive patient coverage health information, resulting in better decision-making and care coordination.
- Users now have a single platform to manage administrative tasks..
- Real-time data and automated workflows streamlined claims submission and prior authorization processes.
- Reduced administrative inefficiencies and lowered operational costs.
5 Signs Your Healthcare System Needs Modernization
If your healthcare system seems like it’s held together with duct tape and sheer will, it might be time to upgrade. Modernization is not just a trend — it is a precondition for relevance in today’s healthcare ecosystem. Below are five signs your system is ready for a refresh, as well as actionable insights to guide you in the right direction.
Issues with performance and scalability
What’s behind this: Your systems are slow, crash under heavy loads, or don’t scale. Perhaps your EHR takes an eternity to pull up patient records, or your imaging software freezes on big files like 3D scans.
Why it matters: Bad performance frustrates users and delays care delivery. Scaling issues restrict your growth, whether it’s the number of patients, new locations, or more advanced features in the system.
Reduced productivity
What’s behind this: Your staff wastes time on manual processes, including manually entering data for new patients, faxing referrals, and reconciling duplicate records. It feels like your systems are working against you, not for you.
Why it matters: Poorly managed workflows waste time and raise the risk of errors. Every minute spent on administrative work is a minute not spent on patient care.
Frequent downtime and unreliable recovery
What’s behind this: Your systems frequently crash, and when they do, recovery is slow and unreliable. You’re using older backup techniques like external drives, and you’re unsure of your disaster recovery plan.
Why it matters: Downtime interrupts patient care and can result in lost revenue. Unreliable recovery puts your data at risk, which is especially dangerous in healthcare.
Security vulnerabilities and lack of compliance
What’s behind this: Your systems are running on outdated software with known vulnerabilities. You’re not sure if you’re fully compliant with regulations like HIPAA or GDPR.
Why it matters: Older systems are a prime target for cyberattacks that can result in data breaches, fines, and reputational damage. Compliance gaps can also result in hefty penalties from regulatory bodies like The Office for Civil Rights (OCR).
Lack of interoperability
What’s behind this: Your platforms don’t ‘communicate’ with one another. Patient information is stuck in data silos — isolated chunks of information held in different systems or departments — which makes assembling a complete view of a patient’s record difficult. You’re faxing records or manually entering data from one system to another.
Why it matters: Fragmented data results in gaps in care, duplicated tests, and frustrated providers. It also makes meeting interoperability standards, such as FHIR, nearly impossible.
If any of these technical red flags sound familiar, it’s time to face the music: your healthcare system needs an update.
The good news? You don’t need to do it all at once. Determine your top pain points, then focus on healthcare solutions that will create the highest impact.
And remember, you are not alone in this. There are many experienced partners who can provide guidance, expertise, and technical support to make your modernization process as seamless and trouble-free as possible. Uptech is one of them.
5 Key Approaches to the Modernization of Legacy Systems In Healthcare
Healthcare software modernization may appear complicated, but it is an essential process if an organization wants to embrace new technologies and stay competitive. As an Associate Delivery Manager, I’ve seen firsthand how the right approach can transform outdated legacy systems into modern and scalable solutions.
I’ll outline the most common approaches to modernization below.
Rehosting (Lift and shift)
This approach involves taking your current system and migrating it to another environment (such as the cloud) with little or no significant modifications to your code. It's like moving your app to a new house.
When to use it: If you’re looking for a quick way to improve the system’s performance or scalability but don’t have the time or budget for a complete overhaul, rehosting is a good choice. If you ever plan on a more extensive modernization down the line, it’s also a great first step.
Pros:
- You can migrate to the cloud in weeks or months, not years.
- Minimal development effort means lower upfront costs.
- Since you’re not changing the code, there’s less chance of introducing bugs.
Cons:
- Doesn’t fix underlying issues, If your system has poor user experience, outdated workflows, or inefficient code, rehosting won’t solve those problems.
- Limited scalability. While the cloud offers scalability, your application’s architecture may still limit performance.
Rehosting is a quick win for organizations that want to have their infrastructure costs reduced and system availability improved without making huge investments.
Refactoring
Refactoring is rewriting an existing codebase to improve its operational efficiency and scalability. It’s like remodeling a home: you make it more usable and modern with moderate changes.
When to use it: If your system is up and running but struggles with performance issues, technical debt, or scalability, refactoring can strengthen your system. It’s also a solid option if you would like to future-proof your system for upcoming big updates.
Pros:
- Optimized code runs faster and uses resources more efficiently.
- Refactored systems scale better.
- It will be easier to add new features or integration with other systems with a clean code base.
Cons:
- Refactoring requires skilled developers and can take months, depending on the size of the system.
- You’ll need a team familiar with your codebase and modern development practices.
Refactoring is a strategic investment for healthcare companies that want to modernize step by step without disrupting operations. It’s ideal for systems that are still functional but need a tune-up to meet modern demands.
Replatforming
Replatforming means moving your system to a new platform (from on-premises to the cloud, for example) and making some code changes to take advantage of the new environment. It’s like upgrading from a gas-powered car to a hybrid: you’re keeping the core functionality but adding modern features.
When to use it: Replatforming is a smart move if you want the benefits of modern platforms (like AWS, Azure, or Google Cloud) but do not want to do a full rewrite. It also may be a good fit if your system is functioning well, but you could use some upgrades to operate best in the cloud.
Pros:
- You have all the advantages of the most modern platforms without the cost of a full rebuild.
- Less commitment than a full rebuild so you can modernize quicker.
- Cloud platforms provide better scalability, resilience, and performance.
Cons:
- Code changes are required. You can’t move to the new platform without changing some of your codebase.
- Not a complete fix. As with rehosting, replatforming does not solve every root problem.
Replatforming is a good option for organizations that want to modernize their infrastructure with manageable costs and risks.
Rebuilding
Rebuilding refers to a complete rewrite of the system from scratch while still keeping the base functionality. It’s like removing an old house and building a new one on the same foundation.
When to use it: If your system is too old or too rigid to do what you need it to, rebuilding is the answer. It’s also a suitable option if you want to use modern technologies such as suitable architecture or AI.
Pros:
- A new system built with modern architecture is easier to scale, update, and maintain.
- You can customize the system exactly as you need it and integrate modern tools.
- A new system will better accommodate future innovations and regulatory changes.
Cons:
- Rebuilding takes a lot of time, money, and other resources.
- Depending on the system's complexity, it can take months or even years to finalize the process.
Rebuilding is a long-term investment for SMBs serious about innovation and scalability. It is perfect for systems that can no longer exist in their current state.
Replacing
Replacing means getting rid of the entire system and embracing a new off-the-shelf solution. It’s like trading in your old car for a brand-new model.
When to use it: If your legacy system is beyond repair, doesn’t support your business needs, or is too expensive to maintain, replacing it with a modern solution is the most effective option.
Pros:
- Off-the-shelf solutions come with advanced features such as cloud integration, advanced analytics, and interoperability.
- You can deploy a new system much faster than rebuilding one from the ground up.
Cons:
- Licensing fees and implementation costs can be expensive.
- It’s hard to find a reliable partner that will handle the technical aspects.
- Switching to a new system may call for major changes to your workflows and other processes.
Replacing is a reasonable choice for companies that want to update fast and employ proven solutions. It is perfect for organizations without the capacity to build or rebuild a system in-house.
Solving Healthcare System Modernization Challenges
Healthcare software modernization isn’t about a tech update but rather a transformation that can redefine how your organization delivers services, operates, and competes with others on the market.
But let’s not sugarcoat things: it’s clear that the process of modernization is anything but simple. As a decision-maker, you have to know what kind of challenges may await you so that you can successfully tackle them and provide the results your organization needs.
Data migration
Transitioning years (or even decades) worth of patient records, compliance data, and operational insights to a new system is a heavy lift. Data drives healthcare — it’s the lifeblood of the industry. Inaccurate or incomplete migration can be the reason for errors in patient care, compliance issues, and operational inefficiencies. Besides, a poorly executed migration can create distrust between staff and patients.
Solution: Focus on auditing, cleaning, and testing your data before migration. ETL (extract, transform, and load) tools, parallel system runs, and backups will help you migrate data without errors, data loss, or compliance violations.
Interoperability
Interoperability is one of the most important things in healthcare systems, but it’s also one of the most difficult problems to solve. Right now, patient data is frequently spread across various systems — electronic health records (EHRs), lab systems, billing platforms, and more. These systems don’t always “communicate” with each other, forming data silos that block care coordination and fracture patient experiences.
Solution: Standardize data formats and use APIs for smooth integration.
FHIR (Fast Healthcare Interoperability Resources), HL7 (Health Level Seven), APIs, and middleware will help you automate manual work and unify patient records.
Compliance
Healthcare is one of the most regulated industries, with laws like HIPAA in the US, GDPR in Europe, and various local rules protecting patient data. Modernizing solutions must not only meet these regulations but also increase the security and privacy of the system. Finding the right balance between innovation and legal requirements is a challenge that requires expertise in both the legal aspects of healthcare and technology.
Solution: Prioritize encrypting data, enforcing strict access controls, and automating compliance monitoring to protect patient privacy and meet regulations like HIPAA and GDPR.
Resistance to change
Healthcare professionals rely on familiar workflows in the legacy systems they use. Disrupting them with new software can lead to resistance, frustration, and short-term dips in productivity.
If modernization in healthcare systems doesn’t involve user-friendly design and seamless adoption, users may resist the new system. The key to success involves proper training and an intuitive UX design.
Solution: Engage users in the early stages, reduce complexity in navigation, and offer onboarding tutorials for easy adoption.
Why Healthcare Software Modernization is a Must
From what I’ve seen, healthcare is no longer what it used to be. Today’s patients are not only seeking care. They want the same convenience and personalization they receive from their favorite apps and services. If you’re still relying on outdated systems, I think you’re not just working harder than you have to — you’re risking your reputation, security, and competitive edge.
This is exactly why I believe modernizing your healthcare software is not an option but an absolute must.
User expectations
Imagine this: you’re a patient trying to schedule a doctor’s appointment. You’re accustomed to one-click shopping, instant messaging, and seamless online experiences. But when you try to schedule your visit, you’re hit with a confusing website, endless phone menus, and a paper form that asks for the same information you’ve already provided three times.
Frustrating, right?
Patients today lack the patience for outdated processes. They want healthcare to be as easy as ordering dinner or streaming a movie. Research done by NICE states that 80% of patients prefer digital communication channels, such as emails or patient portals, for appointment reminders and follow-ups.
If you fail to meet these expectations, your potential patients will seek out someone who does. Modernization of healthcare legacy systems is not only about catching up, but it is also about staying relevant.
Protecting your users’ data and your reputation
Healthcare data is a top-tier asset, so protecting it has become critical. In 2024, the U.S. healthcare sector reported 720 data breaches affecting over 180 million user records.
Outdated systems are often not equipped with the security protections needed to meet data protection regulations today, which places sensitive patient information at risk.
One data breach can cost you millions in fines, legal fees, and lost trust. And let’s be honest — no one wants to use a platform that cannot protect their private data.
Your best data security and reputation protection is modernizing your software. Modern systems come with security features such as encryption, multi-factor authentication, and real-time threat monitoring to keep patient data secure.
Competitive advantage
It’s crowded out there in healthcare. The global Digital Health Market size is expected to be worth around USD 1,190.4 billion by 2032.
Everywhere you look, telehealth startups, retail clinics, and tech-savvy competitors are emerging, and they’re all competing for the same patients. If the medical software you’re using still looks like it’s from the early 2000s, it’s not just patients you’re losing — you’re losing traction.
Modern healthcare software solutions will allow you to provide the latest services, such as remote patient monitoring, AI-powered diagnostics, and personalized health apps. These are not just cool features — they’re competitive advantages that will help you differentiate against your competitors.
What Outcomes You Get After Healthcare Software Modernization with Uptech
At Uptech, we aim to work with you as well as understand your business needs and solutions that bring measurable business impact.
With 9 years in the market, we thrive on solving complex problems. Our experts can help you fully modernize a legacy system, add new features, or integrate emerging technologies like artificial intelligence.
We understand healthcare: We’ve been building healthcare digital products for nearly a decade.
We solve problems: Legacy system modernization? Data migration? Integration of third-party tools? Our experts have been through everything and have the experience to address it.
We drive results: We don’t simply build software — we create solutions that make a difference, whether that’s faster diagnoses, happier patients, or smoother operations.
We’re future-proof: AI, IoT, blockchain — we use the latest tech to keep you ahead of the competition.
Case study: Custom AI-powered medical image processing system
Our client, a private diagnostic clinic, had problems with slow manual medical image analysis. They needed a solution to speed up image processing and reduce manual mistakes. They reached out to Uptech for help with these requirements.
Using our machine learning and healthcare technology expertise, we decided to develop a customized solution that met their specific requirements. Throughout our collaboration, we addressed three primary challenges:
- Data security and compliance
- Blurred text annotations on medical images
- The lack of medical imaging data for model training
Find out how we solved them in our case study.
As an outcome, we developed an AI-based medical image processing system that reduced processing time by up to 30%.
Conclusion
Modernization of healthcare is not an easy task, but it brings many advantages.
Today, the question isn’t whether to modernize but how to do it effectively.
The good news? You don’t have to do it alone.
Partner with experts who will guide you through the whole process and handle all the technical and organizational aspects, so you can focus on what matters most — delivering quality healthcare.
As a software product development company, Uptech is ready to face any system modernization challenge because we know that behind every line of code, there’s a healthcare organization and patients who count on us to get it right.
Ready to modernize? Let’s build a healthcare system that’s ready for tomorrow.
Contact us for a free consultation.