One patient record across three hospitals

Sagarmatha ran three hospitals on three different systems, two of which were no longer supported. A patient treated at more than one site had more than one record, and staff reconciled them by phone.

One constraint was absolute: no downtime. These are working hospitals, and a failed switchover would put patient safety at risk, not just cause inconvenience.

We built a single platform covering admissions, pharmacy, laboratory orders and billing, then moved departments onto it one at a time rather than one hospital at a time.

How we migrated

• A master patient index that removed duplicate records across all three old systems, with clinical staff deciding any uncertain matches.
• Two-way synchronisation during the transition, so any department could switch back within a single shift.
• Pharmacy first, because it carried the least risk and delivered the clearest immediate benefit.
• Billing last, because it depends on everything else.

All three hospitals were using the platform within nine months, with no unplanned downtime. Duplicate patient records fell from an estimated 11% of active patients to under 0.4%, and the time from discharge to final bill dropped from an average of 40 minutes to 12.