The quiet move of a hospital that never sleeps

A deadline that does not wait

The trigger was a date in Microsoft’s calendar. On 14 October 2025, security support for Office 2019 ended. After that, the security updates stop.

Unsupported software keeps running, and that is what makes it treacherous. The next morning every document still opens. No alarm goes off. But every vulnerability found from then on stays open. In healthcare that is not an IT detail. Dutch law requires care providers to work to NEN 7510, the national standard for information security in healthcare. And since 15 August 2026 the Cyberbeveiligingswet, the Dutch implementation of NIS2, has explicitly counted system maintenance and vulnerability handling as part of the duty of care.

Unsupported software keeps working. The protection does not.

There was a shorter route: a newer standalone version of Office, and the same conversation again in a few years. The hospital chose Microsoft 365, with the latest versions, design and features. And it took the step that comes with it: the files moved too. AutoSave, and with it several people working in one document at once, only works with files in OneDrive or SharePoint Online. Not on a network drive, not locally on a PC. Renew only the software and you miss the change that staff notice every single day.

Folders with a double life

On screen, a network drive is a list of folders. In a hospital it is often a junction as well.

A hospital runs on a large landscape of systems: the electronic health record (EHR), lab and imaging, scheduling, HR and finance, with interfaces between them. As in many hospitals, some of those systems lean on the network drive. An application drops an export there at night. A scanner at the front desk sends documents to it. A planner’s Excel workbook reads a list from it at six in the morning to build the day overview for the morning huddle. A letter template points to a fixed path.

You cannot see those threads in File Explorer. You see a folder. You only find out a system was attached to it when the folder is gone. Not with a bang, but quietly: the day overview that is missing at a quarter to eight, the checklist that will not open at three in the morning.

A building that never closes

You can move an office in a weekend. The lights go off at five on Friday, and on Monday everything works again. A hospital has no such weekend. The emergency department keeps going, the wards keep going, the night shift keeps going. Downtime was not an option.

Then there is the data. Under the GDPR, health data is a special category of personal data, the most sensitive kind there is. A citizen service number in a wrongly shared folder is not a slip. It is a data breach.

So every choice in this project came with two questions. Does care keep running? And does patient data stay where it belongs? Only what passed both went ahead.

We did not start with Microsoft 365. We started with a question that sounds simpler than it is: who, and what, is actually looking in those folders?

First the map, then the move

For each drive we mapped what was on it, who owned it and who needed access. Then we followed the threads: applications and interfaces that read or write files, exports from source systems, scan and print flows, shortcuts on workstations, macros and templates with hard-coded paths.

That is detective work. A migration tool copies a file neatly, but it does not rewrite the paths inside it. So we sat down with the application owners, system by system, and made a decision for each dependency:

• Move it to Teams, SharePoint or OneDrive when people collaborate on it.
• Re-point it to a new location when a system only needs a different destination.
• Keep a temporary network path for a system that still depends on one, until its interface has been switched over.

So before the first move, it was settled what would go, what would stay for now and why. Every thread had an owner and a decision.

From drive letters to teams and channels

Once the map was right, everything got a new home. All data from the network drives went into teams, channels and groups in Teams, with SharePoint and OneDrive underneath. The structure follows the organisation, not the old folder tree. Personal files belong in OneDrive. A department gets a team, with channels for its parts. Anything meant for a small circle gets its own restricted space.

Take the management secretary on the afternoon before the management meeting. On a network drive, that is the hour of the pile of PDFs, three versions of the same paper and the email ‘now with the right attachment’. In Teams the meeting pack sits in one place, with the right permissions, and everyone works in the same document. Whoever still owes a contribution can see that too.

One account, the right doors

A hospital is a building full of doors, and not everyone belongs behind every one of them. Digitally, it is no different.

We set up access so that every member of staff has one account, on the local network and in the cloud: hybrid identity. On top of that, rules decide who gets in where. Multi-factor authentication (MFA) is the default. Conditional Access looks at who is signing in, from which device and from where. Sensitive areas can only be reached from managed devices that meet policy.

Then there is the shared workstation on the ward, where several colleagues sit at the same screen in a single shift. It needed its own approach, so the next colleague never lands in the previous one’s session.

The EHR stays the record

The principle was clear: the EHR stays the place for patient data. Teams became the place to work together on everything around the patient: rosters, protocols, team meetings and meeting papers. Not on the record itself.

A good principle alone is not enough. At three in the morning, at the end of a long shift, someone wants to share something quickly. Then the environment itself has to help. So we built the protection in:

• Classification and sensitivity labels per team and site, deciding who has access and whether sharing outside the hospital is allowed.
• Data loss prevention (DLP) that recognises citizen service numbers (BSN) and patient numbers in files, chats and email, and warns or blocks.
• Guest access closed by default. Working with outside parties is a deliberate choice, team by team.
• Retention policies per document type, in line with the hospital’s own retention rules.
• Audit logging aligned with the hospital’s information security policy (NEN 7510). The NEN 7513 logging of who opened a patient record stays in the EHR, where the record lives.
• Data stored in the EU, within Microsoft’s EU Data Boundary.

The hospital made the risk decisions. We made sure the technology carries them out.

The Microsoft 365 migration, one department at a time

Only then did the moving begin. Not in one big bang, but in waves: department by department, location by location.

A wave starts out invisible. In the background the data is copied across while everyone keeps working on the old drive. Delta syncs then pick up only new and changed files.

Then comes the moment itself. Each switch fell in a change window set in advance, away from the busy moments in care: not just before the morning clinic, not in the middle of a shift handover. The old drive went read-only, the final sync ran and the department carried on in Teams. Every wave had a rollback plan ready.

When in doubt, a department does not switch. The schedule gives way to care, not the other way round.

Old and new ran side by side for a while, and for good reason. At ten past three in the morning, a night-shift nurse looks for the checklist for a procedure she carries out a few times a year. There is no IT person beside her and no time for a search. She finds it: in her ward’s channel, or else in the old location, where it can still be read. That safety net is not a luxury. It is the difference between working and searching.

Teams by role, not by manual

Moving files is the visible part. The real work is helping people settle into a different way of working together. A receptionist works differently from an outpatient clinic assistant, and a management secretary differently again. So we coached staff role by role, using their own work. This is what that can look like:

• Front desk and reception: a channel for what is happening that day. A clinic running late, a lift out of order: one message and the whole desk knows, instead of a round of phone calls.
• Medical assistants and outpatient clinic assistants: the morning huddle, room allocation and protocols in one place, and a short message to the doctor without patient details.
• Night shift: the documents needed at night, pinned to the top of the ward’s channel.
• Managers and management secretaries: editing meeting packs together, keeping action lists and meeting in Teams.
• Other roles: the same approach, always starting from their own process.

On switch-over day our people walked the floor to solve questions on the spot. In the days after, extra support stayed in place.

Copilot, the final chapter

Copilot can reach everything a member of staff can reach. If permissions are too broad somewhere, Copilot surfaces that content as easily as a colleague who opens the wrong folder. Only faster. That is why we switch Copilot on only once permissions and labels in the new environment are right.

In this hospital we integrated Microsoft Copilot and trained staff to use it. After a meeting in Teams, the notes are ready: what was discussed, what was decided and who picks up which action. A long email thread becomes a short summary, and a difficult email starts from a first draft. Our rule: Copilot writes the draft, the person checks it and decides.

How the hospital works now

The whole hospital now works in the same Microsoft 365 environment, at every location. From the front desk to the management offices, staff find their files in Teams. A meeting pack is one link instead of a string of attachments. Copilot helps write notes and email, and the person keeps the final word.

What this means for a hospital

• Supported software. Security fixes and improvements arrive continuously, instead of a new version every few years with a new end date.
• One version of every document. Protocols and meeting packs live in one place for every location, with version history.
• Access managed in one place. IT controls centrally who can reach what, and from which device.
• A foundation for the next step, such as wider use of Copilot or automating recurring work.

What else Copilot can do in a hospital

On the same foundation, a hospital can extend Copilot to work that involves no patient data. That was outside this project, but it is within reach:

• summarising long policy documents for a director or manager;
• drafting standard letters, news items and presentations from existing documents;
• a Copilot agent that answers HR questions from the intranet and the collective labour agreement;
• handling frequently asked questions for the service desk.

Microsoft Copilot is not clinical AI. Clinical documentation has its own products, with their own assessment. Every new use starts with the hospital’s own DPIA. The national Dutch DPIAs by SLM Microsoft Rijk and SURF feed into it but do not replace it.

Quarter past seven

It is quarter past seven again. In the outpatient clinic the screens flicker on. The medical assistant logs in, and the template is where it belongs. At the front desk everyone already knows the clinic in room three is running late. Two floors up, the night shift hands over to the day shift. Last night’s checklist is in the ward’s channel.

Nobody in the building is thinking about Microsoft 365. That is how it should be.