Inside the EHR Journey: A CIO’s Perspective on Migration and Implementation

Published: 14 Aug 2025

Author: Precedence Research

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Ismelda Garza, Chief Information Officer of Cuero Regional Hospital in Texas, led the recent migration to Meditech Expanse to pull together the hospital and its five rural health clinics into one electronic health record (EHR) system. Garza is now in the full optimization stage of the project, and she hopes other healthcare leaders can learn from her experience to carry out similar transformations.

The migration decision resulted from the lack of operating efficiencies with two separate systems for both hospital care and ambulatory care. This duality ultimately created workflow inconsistencies, required manual workarounds, and increased the chances for errors. Garza states, "The old technology was getting in the way of patient care." By integrating into a single EHR, the hospital unified the records for all patients and eliminated duplicate testing, increased safety, and clarified operations.

Selecting an implementation partner was also essential to the success of the project. Cuero Regional partnered with CereCore, which provided a flexible and knowledgeable team of Meditech experts with unique clinical experience. This allowed for the seamless support from pre-planning through go-live and well into the future, while allowing the hospital to maintain day-to-day operations while tackling the complexity of the EHR deployment.

Garza has placed great effort into sustaining the momentum and leveraging learning that occurred during implementation with a focus on open communication, governance, and responsiveness to clinician feedback. A weekly change control meeting and daily huddles on the front lines help address immediate and longer-term issues. Like other change initiatives, testing changes to workflows and determining the impact of new processes on the interconnectedness of workflows is also part of the tactics in harnessing clinician feedback.

After a few months, the quality of care has improved with more consistency and efficiencies, and staff satisfaction is starting to show improvement. Minor but meaningful upgrades, like replacing antique ER computers with models able to support clinical workflows, have improved ways of working. Standard plastics created by DSRIP for order sets also took time for clinical teams to adapt, but the enduring help of staff to set expectations around use has made trust with care teams easier to develop through processes.

Moving forward, Cuero Regional is cautiously investigating potential AI applications, particularly in medical scribing, cybersecurity, and integrating workflows that need to be prioritized. From Garza's perspective, optimizing EHR is not a project or a technology initiative; it is a continuous journey from a care delivery perspective, and ultimately about providing safer, more reliable, and patient-centered care.

Hospital CIO offers insights on EHR migration, implementation and optimization | Healthcare IT News