Representative engagement: this case study combines typical scope, timelines, and outcomes from Access Evolved modernization projects. Organization details are illustrative, and results will vary by system and organization.
A 250-person regional behavioral health provider replaced a 15-year-old Microsoft Access database with Power Apps, Dataverse, and Power Automate in 18 weeks. Today the organization saves roughly 4,300 staff hours a year and about $195,000 annually, recovering its investment in under eight months.
At a glance
- Organization: Regional behavioral health and therapy provider, 4 locations, ~250 staff
- Legacy system: Microsoft Access (split front-end/back-end on a shared drive), built in 2009
- New platform: Power Apps (model-driven and canvas), Dataverse, Power Automate, Power BI, SharePoint
- Timeline: 18 weeks from diagnostic to go-live, plus 4 weeks of post-launch support
- Result: ~4,300 hours/year saved, ~$195,000/year net savings, payback in about 7–8 months
The Organization and Its Access Database
The organization’s operations ran on an Access database built in 2009 by a former office manager. Over 15 years it grew to about 140 tables, 300+ queries, 60 forms, and several thousand lines of undocumented VBA.
It handled nearly everything the organization did outside the EHR:
- Client intake and referral tracking
- Clinician scheduling across four locations
- Insurance authorization tracking and expiration dates
- Incident reporting and follow-up
- Staff credentials and training records
- Monthly billing exports and board and compliance reporting
The database sat on a shared network drive, with up to 18 staff connected at once, several of them over VPN. The person who built it had left years earlier, and no one on staff fully understood how it worked.
Why They Needed to Modernize
A compliance audit forced the decision: auditors flagged that the database had no audit trail and no role-based security. Anyone with access to the shared drive could open, change, or copy client records.
The audit finding sat on top of problems staff had been working around for years:
- Frequent corruption. The back-end corrupted roughly once a month, usually when VPN users dropped connection mid-edit. Each incident meant hours of downtime and an emergency repair call.
- No remote or mobile access. Clinicians in the field wrote notes on paper and re-entered them at the office, often days later.
- Duplicate data entry. Intake staff typed the same client information into Access, Excel trackers, and the billing system.
- Missed authorization renewals. Expiration dates lived in a report someone had to remember to run. Lapsed authorizations led to denied claims, about $45,000 a year in lost revenue.
- Manual reporting. Monthly board and compliance reports took two staff members about two days to compile by hand.
- Growth limits. A fifth location was planned, and the database was already slow with 18 users.
Leadership’s question was not whether to replace the system, but how to do it without disrupting client care or losing 15 years of data and business rules.
Our Approach: Seven Phases Over 18 Weeks
We kept the Access database running and stable for the entire project, so staff never lost a working system while the new one was built.
- Diagnostic and documentation (weeks 1–2). We stabilized the Access back-end, then mapped every table, relationship, query, form, and VBA routine. Interviews with intake, scheduling, billing, and clinical staff surfaced the business rules that only lived in people’s heads. The result was a written blueprint the client owns regardless of what comes next.
- Data cleanup and Dataverse design (weeks 3–5). We found about 4,000 duplicate client records and years of inconsistent values. We cleaned and standardized the data, then designed a normalized Dataverse model with role-based security: clinicians see only their caseloads, billing sees only billing fields.
- App build (weeks 6–13). We built a model-driven Power App for back-office staff (intake, scheduling, authorizations, credentials) and a canvas mobile app for clinicians to document visits and incidents from a phone or tablet. Staff reviewed working screens every two weeks.
- Automation (weeks 10–14). Power Automate replaced the VBA and the manual routines: authorization expiration alerts at 30, 14, and 7 days, incident report routing to supervisors, and the monthly billing export.
- Reporting (weeks 13–15). Power BI dashboards replaced the hand-built monthly reports, with board and compliance views that refresh automatically.
- Parallel run and migration (weeks 16–17). Both systems ran side by side for two weeks while we reconciled record counts and outputs. Final data migration happened over a weekend.
- Training and go-live (week 18), then four weeks of hypercare. Role-based training sessions, short how-to videos, and same-day support for issues after launch. The Access database was archived read-only.
Results: Time and Money Saved
The organization now saves about 4,300 staff hours a year, and the audit finding was closed at the next review.
| Area | Before | After | Hours saved per year |
|---|---|---|---|
| Clinician documentation | Paper notes re-entered at the office | Entered once on mobile; ~15 min/day saved for 40 clinicians | ~2,300 |
| Duplicate data entry | ~20 hrs/week across intake and billing | Eliminated | ~1,000 |
| Database downtime and repairs | ~70 lost staff-hours a month | No corruption incidents since go-live | ~840 |
| Monthly reporting | ~16 hrs/month by hand | Under 1 hr/month (dashboards) | ~180 |
| Total | ~4,320 |
Annual financial impact
- Staff time recovered (4,320 hrs at a blended $38/hr): ~$164,000
- Denied claims from lapsed authorizations, now caught by automated alerts: ~$45,000 recovered
- Emergency repair calls eliminated: ~$8,000
- Less added Power Platform licensing: –$22,000
- Net savings: ~$195,000 per year
With a project investment of about $120,000, the organization recovered its cost in roughly 7–8 months.
Beyond the numbers, the system now supports the fifth location without changes, clinicians no longer carry paper, and leadership sees authorization and incident status in real time instead of at month-end.
What Made It Work
- Stabilize first, migrate second. Keeping Access running during the build meant no disruption to client care.
- Document before building. The blueprint from phase one captured business rules that would otherwise have been lost.
- Build for each role. Back-office staff and field clinicians got different apps designed around how they actually work.
- Prove it before cutover. Two weeks of parallel running caught data issues before they reached production.
Is your organization running on an Access database that only one person understands? Book a free diagnostic and we’ll show you what a modernization path would look like for your system.