What Most Healthcare Cloud Migrations Get Wrong (And How To Get It Right)

Forbes

a day ago

Sandipan Biswas | MS Computer Sc | MBA | Director of Engineering, Fortune 20 Healthcare | Senior Member - IEEE | Independent Researcher.
Cloud adoption in healthcare has seen dramatic acceleration, driven by the promise of scale, efficiency and innovation. But beneath the surface of this progress lies a more complex reality. Migration to the cloud, especially in healthcare, is not just about moving workloads. It is a strategic redefinition of how data, systems and compliance interact. When these migrations fail, the impact can be more than just financial. It can affect clinical care, breach regulatory boundaries and erode patient trust.
Healthcare has unique demands that other sectors do not face. Regulations like HIPAA, the importance of data lineage and the mission-critical nature of patient information mean that success is not defined by cloud adoption alone. It is defined by how well organizations adapt their architecture, governance and operations to meet the evolving demands of both technology and care delivery.
Across the healthcare technology landscape, certain patterns tend to repeat. These issues don't usually stem from lack of experience. The real problem is a gap in mindset. Many teams approach cloud migration as a technical upgrade, but what's really needed is a shift in how they think about architecture, governance and daily operations. Here are five recurring missteps that often go unnoticed until they create costly setbacks. Each one can be avoided with the right approach.
1. Treating Cloud Migration As A Simple Lift And Shift
Many organizations view cloud migration as a way to reduce costs or eliminate on-premise infrastructure. That thinking often leads to a "lift and shift" approach, where legacy systems are rehosted in cloud environments without meaningful architectural changes. While this may meet short-term goals, it frequently results in performance degradation, inflated cloud bills and missed opportunities for modernization.
The better approach is to use migration as a moment to redesign. Instead of porting over static workflows, teams should consider modular designs, event-driven architectures and serverless computing where appropriate. Batch jobs designed for monolithic environments can evolve into real-time processing pipelines. A migration that enhances agility, performance and scalability is far more valuable than one that merely replicates old systems in new infrastructure.
2. Overlooking Governance Until It Is Too Late
In highly regulated environments, data governance is not optional. Yet in many cloud projects, it is deprioritized or deferred until after deployment. This creates avoidable compliance risks and slows down innovation when teams are forced to retrofit controls later. Healthcare data must be handled with clarity around ownership, access, lineage and lifecycle.
Successful governance strategies start before a single workload is moved. This includes defining stewardship roles, data classification schemes, tagging policies and access protocols. Cloud-native tools such as AWS Lake Formation and Google Cloud Data Catalog help automate these tasks, but only when there is a strong governance foundation in place. When governance is embedded into the architecture from day one, compliance becomes a continuous capability rather than a reactive fix.
3. Assuming Security Comes Built In
It is easy to assume that major cloud providers offer baked-in security protections. While the platforms are secure by design, the responsibility to configure and maintain those protections lies with the user. Misconfigured identity policies, open storage buckets and unencrypted datasets are some of the most common issues uncovered during security audits.
Security in healthcare cloud environments must be intentional. Encryption at rest and in transit should be a default. Identity and access management must follow the principle of least privilege. Logging, anomaly detection and regular policy reviews are essential. The stakes are high. A single security lapse can lead to data breaches that not only incur fines but also undermine trust in care delivery.
4. Ignoring Observability Until A Problem Occurs
Without visibility into how systems behave, even minor issues can become major outages. Many teams invest heavily in infrastructure but forget to build in the observability that makes maintenance and improvement possible. In healthcare, the inability to detect performance issues or trace errors can have serious consequences for both operations and compliance.
Observability needs to be a design consideration, not an afterthought. Centralized logging, metrics dashboards and distributed tracing allow teams to detect anomalies early, diagnose root causes quickly and meet audit requirements. These capabilities are not only useful for operational uptime but are also vital in meeting the transparency requirements of healthcare regulators and stakeholders.
5. Thinking Migration Ends At Go-Live
One of the most persistent myths is that migration is a one-time project. Teams often disband after go-live, with no long-term ownership plan in place. But cloud adoption is not a destination. It is a continuous journey. The needs of users, the growth of data and changes in clinical workflows mean that cloud systems must evolve over time.
Organizations that succeed in the long run treat post-migration operations as a critical phase. They establish cloud centers of excellence, create feedback loops with users and maintain governance and security as living practices. Regular audits, performance tuning and architectural updates are part of this phase. Cloud transformation is sustainable only when it is owned beyond the project timeline.
Conclusion
Migrating to the cloud is a major milestone for any healthcare organization. But it is only one part of a much larger transformation. The cloud offers unprecedented flexibility, but that flexibility can become a liability if not handled with care. Success depends on more than technical execution. It requires foresight, planning and a willingness to treat cloud migration as a long-term strategic investment.
By avoiding the common traps of rushed rehosting, delayed governance, weak security, limited observability and short-term thinking, healthcare organizations can build systems that are secure, compliant and ready to support innovation. With the right foundation, the cloud can truly enable the future of connected, data-driven healthcare.
Forbes Technology Council is an invitation-only community for world-class CIOs, CTOs and technology executives. Do I qualify?