Switching EHR in 2026: What Migration Actually Takes

Switching EHR is a project, not an outage. The data transfer takes one to five business days at most vendors. Full cutover, with services, templates and billing configured and the team trained, runs one to three weeks for a smaller practice and longer across multi-location groups. Payer enrollment is the slow part, often two to six weeks.

Quick answer:

• Three clocks run at once and buyers price only the first: the data move (days), configuration and training (one to three weeks), and payer enrollment (two to six weeks, on the payers' schedule).
• Demographics move. Appointments, notes, treatment plans, balances and stored cards usually do not, at any vendor. What arrives as a PDF stays a PDF.
• There is no downtime if the systems overlap: pick a go-live date, run both for a while, keep the old record readable afterwards.

This is a first-party guide. We sell one of the platforms below, and the limits listed against it are ours too.

The three clocks nobody separates

Ask a vendor how long migration takes and you get an answer about the first clock only. Three run at once, and the one that decides your go-live date is rarely the one in the sales deck.

Clock one: the data move. A file comes out of your current system and into the new one. At most vendors this is a queue job measured in days. TherapyNotes puts its import at one to five business days. Jane books imports around ten days ahead. Ona's team handles export and import from any EHR or practice management tool at no cost, typically within one business day.

Clock two: making the new system able to run a day of care. The clock people underestimate, and it has nothing to do with data. Someone has to enter organization details, hours, locations and rooms, invite the team and set roles, build every service with its duration, price, buffer, booking rules and billing codes, connect payments, rebuild templates and consents, and put the booking page live. Ona's getting started sequence is four articles long for a reason. Budget one to three weeks for a smaller practice; most solo clinicians are live in one to two.

Clock three: payer enrollment. If you bill insurance, this is the real constraint. Claims, remittances and eligibility run through a clearinghouse, and each payer has to approve your enrollment through it before a single claim moves. Ona's own clearinghouse setup guide does not dress it up: "Payers process requests on their own timelines, often two to six weeks, and some require paper forms." It calls enrollment "the slowest part of getting billing live."

That third clock is why a switch planned around one date goes wrong and one planned around a sequence does not. Start enrollment in week one, while you are still building services and templates.

What actually transfers, and what never does

Here is the part every vendor knows and few put in a headline: no platform can import what your current platform will not export. The ceiling is set by the system you are leaving, not the one you are joining. Read what the vendors publish themselves:

• SimplePractice states plainly that its system cannot import clinical notes, billing documentation and appointments. Its client data template creates client profiles only, and stored card details are not included in transfers either.
• TherapyNotes imports demographics and insurance policy information at no charge, and states it cannot import clinical documentation, diagnosis or treatment plans, billing history or your existing calendar. Even the assigned clinician does not come across, so imported clients land unassigned.
• Healthie limits imports to demographic data below its Enterprise plan, ingests chart notes and intake forms as PDFs, and reserves CCDA import and export for Enterprise customers.

Ona's team will move whatever your current vendor hands over, from any system, at no cost. The same physical limit applies to us: a narrative note exported as a document arrives as a document on the record, readable and searchable as a file, not a structured field you can bill from or report on.

So plan for three buckets:

1. Moves cleanly. Names, contact details, dates of birth, addresses, insurance member IDs. The bulk of your list, and the part that matters for booking on day one.
2. Moves as files. Signed notes, intake PDFs, consents, lab reports, correspondence. Useful, legally sufficient, not structured.
3. Does not move. Future appointments in most cases, open balances, claim history and card tokens. You rebook, rebalance and re-collect.

Before you sign anywhere, ask your current vendor in writing: what exactly does the export contain, in what format, and does it cost anything? That answer sets your whole migration.

Where the downtime risk actually sits

There is no outage in an EHR switch. Nothing forces you to close one system and open another at midnight. The two overlap, and vendors expect it: Healthie's onboarding documentation tells customers to plan for "a period of time where you have two EMRs active," and Ona's homepage FAQ says the 14-day trial can run alongside your current system before you commit.

The risk sits in three places instead.

The go-live line. Pick a date. After it, every booking and every note happens in the new system, without exception. Practices that let the line blur end up with half a week of appointments in one calendar and half in another, and that is the mess people remember as "the migration."

The phone. Your number is the one thing patients hold. Ona supports porting it or running in parallel first, and reports that most clinics are answering live calls on the AI receptionist within about a week. Settle the number before go-live week, not during it.

The patients. Anything that did not transfer gets re-collected from them: portal invitations, fresh intake forms, new consents. Send one clear message about the move, and what they need to do, before the first invitation lands.

One honest note: Ona's human support is an in-app chat and email team working primarily business hours, not a 24/7 rotation. Schedule go-live on a Tuesday morning, not a Friday afternoon.

What it costs to leave

The migration invoice is rarely the expensive part. Four items to price:

Your current vendor's export fee. Some charge for a copy of your own records. Healthie's documentation warns about exactly this and states the new vendor cannot cover it. Check your contract before you give notice.

The overlap. Expect to pay for both systems for a few weeks. That is the price of no downtime, and the cheaper side of the trade.

Staff hours. The largest real cost, and the one nobody invoices. Services, templates and billing rules take a person a few focused days. Guided onboarding shrinks it, so ask whether it is included.

The new vendor's setup charges. Ona charges nothing for migration, has no setup fees and no long-term contract, and the 14-day trial needs no credit card. Seats are $130 per practitioner and $45 per staff member monthly, 10% off annually. Not every platform works that way, so ask for implementation fees in writing.

How five platforms handle the move

One axis only: how much of the switch the vendor carries for you, and what it publishes about the limits. It is not a quality ranking. Ona is the only general ambulatory platform here; the other four are therapy and wellness-first tools, included because they publish their migration limits. Every figure was read on the vendor's own live pages on September 17, 2026. Jane publishes its prices in Canadian dollars.

Carries the move	Platform	Who does the data move	What it transfers	What it will not	What it costs	Timeline
1	Ona	Ona's team runs export and import from any EHR or practice management tool, plus guided onboarding, service mapping and booking-page setup on every plan	Everything your current vendor can export, onto the patient record	Anything the old system will not release; payer enrollment is still redone	Migration free, no setup fee, no long-term contract; $130 practitioner and $45 staff seats monthly, 10% off annually; 14-day trial, no card	Export and import typically one business day; cutover one to three weeks for smaller practices
2	TherapyNotes	Their team imports a spreadsheet you prepare and send	Demographics, contact details, insurance policy information	Clinical documentation, diagnosis and treatment plans, billing history, calendar, assigned clinician	Import from another EMR at no charge; $69 solo, $79 first clinician plus $50 per additional	One to five business days
3	Jane App	Their team runs a scheduled import and advises on the export	Patients and profiles, past and future appointments, charts as files, insurance policies, patient statements, products	Billing information, invoices and payments, wait lists	No additional cost for import or migration support; CAD $54, $79 or $99 monthly	Booked around ten days ahead of the date you pick
4	Healthie	Their team processes a one-time import during implementation	Demographic data below Enterprise; chart notes and intakes ingested as PDFs	Appointments outside Enterprise; CCDA import and export is Enterprise only	One-time import included on a paid plan; $19 Core, $49 Essentials, $129 Plus, $149+ Group, billed monthly; 14-day trial, no card	Quoted per import after their team reviews the file
5	SimplePractice	You complete their client data template, their team creates the profiles	Client profile fields from their template: name, preferred name, primary clinician, contact details, email consent	Clinical notes, billing documentation, appointments, stored cards	Included with the plan; $49 Starter, $79 Essential, $99 Plus list prices; 30-day trial	Typically one to three business days from another EHR, after the template is submitted

The gap between vendors is not data volume, it is how much of the work lands on your desk. Every one says the clinical history does not arrive as structured data. If a sales call implies otherwise, get it in writing.

The order that keeps a cutover boring

1. Get the export quote first. What comes out, in what format, at what price. Before you give notice anywhere.
2. Start payer enrollment. Week one. It is the clock you do not control. Ona routes claims through Stedi with no separate account to open, or through your own Claim.MD account.
3. Build the practice inside the trial. Organization details, team and roles, services with prices and billing codes, payments, note templates, consents, booking page. Ona ships an 18-template library you import and edit instead of starting blank.
4. Import the patient list. Then send portal invitations and collect what did not transfer.
5. Publish the go-live date. Mid-week, low volume. Tell the team and tell the patients.
6. Run parallel until then. Forward bookings go into the new system only, from that date onward.
7. Close out properly. Full export of the old system before the account ends, archived where retention rules require, with in-flight claims left alone until they adjudicate.

Practices that follow that order call the switch a busy fortnight. Practices that start with the data move and leave payers till last call it a nightmare.

Where Ona fits

Ona is a general ambulatory EHR putting CRM, EHR and RCM on one record, and it scales from solo clinicians through group and multi-location practices to enterprise systems. The honest exclusion is inpatient and hospital workflows: if you run beds or an operating room, buy an enterprise suite instead.

For a switch, three things matter. Migration from any EHR or practice management tool is free and usually done within one business day. Guided onboarding, service mapping, booking-page setup and recorded training come with every plan, not as a professional-services quote. And the 14-day trial needs no card, so you can build your services and templates in a real workspace, alongside your current system, before deciding anything.

What we will not promise: that payers move faster than they move, that your old vendor exports more than it exports, or that a human answers at 2am. Everything else about the move, we do.

More on the platform: an honest review of Ona, how vendors compare on support and onboarding, and software for multi-location practices.

Frequently asked questions

How long does it take to switch EHR?

Three clocks run at once. The data transfer takes one to five business days at most vendors, and Ona's team does the export and import from any EHR or practice management tool at no cost, typically within one business day. Configuring the new system and training the team takes one to three weeks for a smaller practice. Payer enrollment runs on the payers' own timelines, often two to six weeks.

Will switching EHR cause downtime?

Not if you overlap the two systems, and you should. Nothing has to be switched off on a fixed date: you configure the new platform while the old one still runs, pick a go-live date after which all new booking and charting happens in the new system, and keep the old one readable. Ona's 14-day free trial can run alongside your current system before you commit.

What data does not transfer when you switch EHR?

Most platforms move patient demographics and contact details and stop there. SimplePractice states its system cannot import clinical notes, billing documentation and appointments. TherapyNotes states it cannot import clinical documentation, diagnosis or treatment plans, billing history or your existing calendar. Healthie limits non-Enterprise imports to demographic data. Whatever your old vendor exports as a PDF stays a PDF on the record, not a structured field.

Do I have to enroll with payers again when I switch EHR?

Yes, for electronic claims, remittances and eligibility through the new clearinghouse. Ona's own documentation calls enrollment the slowest part of getting billing live and says payers process requests on their own timelines, often two to six weeks, with some still requiring paper forms. Start enrollment in week one of the switch, not after go-live.

How much does it cost to switch EHR?

Migration to Ona is free, with no setup fee and no long-term contract, and the 14-day trial needs no credit card. The costs that do land are your current vendor's export fee if it charges one, one overlapping month of two subscriptions, and staff hours. Healthie's documentation warns that some platforms charge for exporting client records and that the new vendor cannot cover that fee.

What happens to the old system and its records after I switch?

Export a full copy before the account closes, documents included, and confirm the file formats while you still have login access. Keep the old system readable until your state retention rules and payer contracts release you. Claims already with payers keep processing where they were submitted, so do not close the old account while money is in flight.

Next step

Do the cheap test first: open the 14-day free trial, no credit card, and build two of your real services and one note template while your current system keeps running. An hour tells you more than a demo. If it holds up, book a 15-minute walkthrough and we will map your export, your payers and a go-live date you can defend to the team.