Therap Emails and Says, “You Can Download Your Data."

Part 1 of a documented EHR transition

Hi, I'm Setworks!

We’re an HCBS provider at the start of a journey that many organizations eventually face and very few document honestly: moving from one EHR to another.

In our case, that means transitioning from Therap to SetWorks—driven by operational realities, changing expectations around data and oversight, and a growing recognition that legacy systems weren’t built for where HCBS is heading.

This is the first post in a documented series about that transition.

Not a case study. Not a vendor comparison. Not a “best practices” retrospective written after the hard parts are over.

This is the record of what it actually looks like while you’re in it.

It starts with an email.

The Email

Therap emails and says, calmly and correctly: You can download your data.

No drama. No warnings. Just a statement of ownership.

On the surface, that sounds like reassurance. In reality, it’s the moment the work becomes real.

What That Sentence Actually Means

When an EHR says “you can download your data,” they are offering access—not continuity.

You can take the records. You can store the files. You can meet retention requirements.

What you cannot take with you is the system that made those records usable.

The logic. The relationships .The structure connecting services, authorizations, billing, and compliance.

This distinction matters—to providers trying to operate, to health-tech teams designing replacements, and to state leaders assuming portability is solved because exports exist.

Because “Our Data” Isn’t a Folder

In HCBS, data isn’t neat.

It’s years of daily notes written by staff at the end of long shifts. It’s plans revised over time. It’s assessments tied to authorizations tied to billing tied to real people’s lives.

All of that lived inside a system that understood those connections.

Once you download it, that understanding disappears. You don’t download meaning. You download files.

And yes—this is the part where we all briefly pretend that every file is perfectly named, consistently labeled across years and service lines, and will be immediately intelligible to whoever opens the archive next.

Documents Travel. Meaning Does Not.

A downloaded document can prove a service occurred. It cannot show patterns. It cannot support quality oversight. It cannot answer new questions.

Inside an EHR, documentation is alive. It knows what it belongs to and why it exists. Once exported, that intelligence is gone.

What remains is evidence—important, necessary evidence—but frozen in time.

This is why moving from one EHR to another is not a transfer. It’s a rebuild.

The Cost Isn’t the Download. It’s the Decisions.

Yes, depending on what you choose to keep, downloading data can take a long time.

But the real work isn’t clicking export. It’s deciding:

What must remain operational

What only needs to be retrievable

What has future value

What we’re finally ready to let go

“Download everything just in case” feels safe. In practice, it creates archives no one fully understands and no one wants to own—especially once the original staff, workflows, and system logic are gone.

Archive Is Not a Failure State

One of the earliest—and most important—shifts we’ve made is separating operational data from archival data.

SetWorks is where we want living data: structured, reportable, and usable going forward.

Archives serve a different purpose. They exist to defend decisions, meet retention requirements, and provide historical context when needed. They do not need to function like an EHR.

Once that distinction is clear, the transition becomes manageable.

Why We’re Documenting This Publicly

We’re sharing this process because this part of EHR transitions is usually invisible.

Providers are told what to do, rarely what it actually feels like. Health-tech teams see implementations, not closures. State leaders see compliance outcomes, not the labor required to get there.

This series is an attempt to make that middle visible.

Where We Are Now

Right now, we’re:

• Treating the download as a controlled closure, not a fire drill

• Designing our archive intentionally, not emotionally

• Building SetWorks around clarity, not nostalgia

• Letting history inform the future without recreating old silos

It’s slower than expected. It’s also far more honest.

What Comes Next

Future posts in this series will cover:

• What we’re choosing not to download—and why

• How we’re defining archive vs operational data

• What surprised us about retention, risk, and audits

• How this changes the way we think about documentation altogether

This transition didn’t start with a contract or a kickoff call.

It started with an email that sounded simple and wasn’t.

You can download your data.

What we’re learning is that the hardest part isn’t exporting files.

It’s deciding what matters enough to carry forward—and building systems that respect the work that came before.