Migrating to Microsoft Teams Phone in Healthcare: Guide & Checklist

2. Know what you have 

Healthcare estates grow through acquisition, affiliation, and expansion. The result is rarely documented in one place. A large system might run several PBX versions, hundreds of sites, thousands of numbers, undocumented call flows, and critical analog endpoints no one has audited in years. Mapping all of it is the first step, and often the first time IT sees the whole picture. 

Physical sites

• Catalog hospitals, clinics, diagnostic centers, care homes, contact centers, head office, and acquired sites. Note which are patient-critical.

• Define redundancy and failover for any site where an outage affects care, not just convenience.

 Technologies in use

• Most providers run Avaya, Cisco, Mitel, or NEC systems installed years or decades ago. List every PBX, SIP trunk, gateway, and carrier relationship.

• Give acquired sites particular scrutiny. They hide undocumented carriers, missing SLAs, and number estates no central team has reviewed.

• Older equipment needs more preparation, testing, and cutover planning than newer kit. That shapes budget and timelines.

How systems work together

• Map integration points with directory services, email, and clinical or operational systems.

• Map data flows for user data, call routing, and voicemail so nothing breaks at cutover.

Users, devices, and numbers 

• Analog and clinical endpoints: Fax machines, overhead paging, nurse stations, elevator/lift phones, door entry, alarm lines, DECT handsets, and emergency phones. These keep sites running and cannot be unplugged.

• Shared and common-area devices: Reception desks, waiting areas, treatment rooms, and break rooms need shared accounts and uninterrupted service through cutover.

• Numbers: Document current assignments and usage, including shared numbers, emergency lines, and numbers tied to alarms or monitoring.

 A full PBX audit maps the environment in its entirety, every number, device, and carrier relationship. It gives you the single view the rest of the project depends on. 

3. Know what you want

Migrating to Teams Phone is a chance to do things differently, not to replicate an old PBX. That means informed decisions about connectivity, devices, numbering, and how the analog estate joins the new environment. 

• Choose your connectivity models. Weigh Operator Connect, Direct Routing, and Calling Plans. For healthcare the answer is usually a mix: Operator Connect where speed and simplicity matter, Direct Routing for sites with PBX coexistence, complex routing, analog integration, or local survivability needs. Both run together under one provider relationship. We cover the decision in detail in our guide.

• Plan for analog devices, not around them. Paging, door entry, fax, alarms, lift phones, and DECT do not need physical replacement to join cloud voice. SIP Connect brings each device into the network as a SIP endpoint, so the site keeps working while migration continues in the background.

• Separate porting from migration. If you already have SIP trunks or a SIP-capable PBX, get the port out of the way first. Your provider controls routing between the legacy PBX and Teams, so the port never has to sync with cutover.

• Use a migration trunk. Port the numbers, keep them on the old system, then route them to Teams site by site as testing completes.

• Consider starting fresh. Where users are not tied to a fixed-line number, new numbers can make a site's cutover faster.

• Identify additional services. Call recording for quality or compliance, encryption, and integration with alarm, monitoring, or clinical applications all need planning up front rather than retrofitting.

Do things differently 

• Which legacy features do you really need? Some can be replicated in Teams, some need a workaround, and some only existed because the old system required them.

• What can Teams Phone do that your PBX cannot? Call queues, auto-attendants, and self-service routing can replace manual processes that currently consume engineering time.

4. Know where you want to deploy

This is where healthcare requirements diverge by region, and where the rules carry legal weight. Emergency calling and patient-data law change the network design, the architecture, and the timeline. Map them for every market in scope before deployment begins. Our guide to E911 compliance for enterprises using VoIP covers the detail. 

United States 

• E911 and dispatchable location. Every 911 call has to deliver a location precise enough for responders to find the caller: building, floor, department, across multi-building campuses and mobile staff.

• Kari's Law and RAY BAUM's Act make accurate emergency location a legal requirement, not an optional configuration.

• HIPAA and PHI. Teams can run in HIPAA-regulated environments with the right agreements and controls. The platform being capable does not make your deployment compliant: that responsibility is shared. 

United Kingdom

• The PSTN switch-off. Traditional analog lines are being retired, targeted for January 2027. Anything still on them, including fax, elevator/lift phones, door entry, and alarms, needs a migration path before they disappear.

• 999 and 112 emergency calling. Calls have to route correctly and carry accurate location across multi-building hospitals and multi-site care operators.

• UK GDPR. Providers handle special-category health data, so voice that touches patient workflows needs governed, secured infrastructure

5. Know the network underneath

 A Teams Phone migration only works if the network beneath it can carry real-time voice. The connectivity model decides how calls reach the PSTN. The WAN decides whether they hold up once they are live. In most healthcare estates this is the part that goes unexamined: sites were cabled for data years ago, voice was added later, and no single team owns the path end to end. 

 This matters more once voice moves to Teams. Calls share the same links as imaging, EHR traffic, and everything else the site runs. A network that was never tuned for real-time traffic shows it the moment clinicians are live on it: jitter, dropped calls, and no clear owner of the root cause.

A few things worth mapping before cutover:

• Circuits and carriers per site. Estates that grew through acquisition usually run a different carrier at every site, with separate contracts and no single owner. Document what each site runs and where voice and data share a path.

• Real-time traffic handling. Voice needs prioritizing across the WAN, not filtering through a firewall in the path. SD-WAN can tune branch, clinic, and remote sites for voice. Legacy MPLS often hairpins traffic and is slow to change.

• Resilience at single-circuit sites. Clinics and remote locations frequently run on one path with no independent failover. LTE/5G can provide backup or Day One connectivity where a single last-mile failure would otherwise take a whole site offline.

• Segmentation for regulated traffic. HIPAA, PCI, and OT requirements shape the network design. Traffic segmentation and site-level controls need planning up front, not retrofitting.

• Cloud on-ramps. Sites in major data center fabrics such as Equinix, Megaport, and Digital Realty can private-connect to cloud and voice platforms rather than routing everything over the public internet.

The underlying network is the layer the rest of the migration depends on. Auditing it alongside the PBX gives you one view of both: what carries the calls, and what the calls run on. 

6. Know how to get there

Healthcare migrations carry more variables than most: live clinical operations, analog dependencies, security boundaries, and stakeholders who span the boardroom to the front desk. This is where it comes together.

7. How Pure IP helps

We give healthcare IT teams a controlled path to Teams Phone: auditing the estate, connecting Teams alongside existing systems, keeping analog and emergency devices working, securing the traffic, and migrating in phases.

• PBX auditing maps numbers, devices, carriers, call flows, and dependencies before you migrate.

• Direct Routing and Operator Connect connect Teams to the PSTN. Operator Connect for speed, Direct Routing for complex and legacy-heavy sites, running together under one relationship. See our Operator Connect guide.

• SIP Connect brings fax, paging, lift phones, door entry, alarms, and DECT into cloud voice without physical replacement.

• Managed SBC Service runs the secure gatekeeper between Teams and the PSTN: monitoring, updates, backups, and change management.

• Emergency Calling supports E911 and dispatchable location in the US and 999 and 112 in the UK across multi-building sites.

• Global Network Services consolidates a multi-carrier estate under one team, one bill, and one NOC: managed SD-WAN, dedicated internet access, managed WAN, and LTE/5G backup, run end to end on the network that carries Pure IP voice.

8. Quick decision guide 

9. Frequently asked questions

Does Microsoft Teams Phone include connection to the public phone network?

No. Teams Phone gives you the calling experience, but you still need a PSTN connection to reach the outside world. That comes through Calling Plans, Operator Connect, Direct Routing, or Teams Phone Mobile. For most healthcare estates the answer is a mix.

Is Teams Phone HIPAA compliant?

Teams can run in a HIPAA-regulated environment with the right Microsoft agreements, services, and controls in place. Call recording, voicemail, logs, support access, and third-party relationships all need to be governed.

How do fax, paging, and lift phones work after migration?

They do not need replacing. SIP Connect brings each analog or specialty device into the cloud voice environment as a SIP endpoint, so clinical, facilities, and admin teams keep the devices they rely on while users move to Teams Phone.

How does our underlying network affect a Teams Phone migration?

Teams Phone carries voice as real-time traffic over your data network and the internet, so latency, jitter, and packet loss show up directly as dropped, delayed, or garbled calls. Before migrating, check available bandwidth at each site, whether voice is prioritized over other traffic, and how resilient each location's connectivity is. Patient-critical sites may need redundant connectivity or local survivability so a network blip does not take voice down. We audit the network alongside the voice estate, so call quality is built in, not discovered at go-live.

Can we keep our existing phone numbers?

Yes. Patient-facing numbers such as appointment lines, clinic and referral desks, and reception can be ported to Teams Phone, and keeping them is usually essential so patients are not disrupted. The key is to separate porting from cutover: port the numbers first, keep them routed to the old system, then move them to Teams site by site as testing completes. Where a user or team is not tied to a fixed number, starting fresh can make that site's cutover faster.

How long does a healthcare migration take?

There is no single figure. It depends on the number of sites, how many PBXs and carriers are in play, the volume of analog and clinical devices, and the regulatory scope of each region. What is consistent is the approach: a PBX audit first to establish the true picture, then a phased, site-by-site rollout that keeps care running throughout rather than a single high-risk cutover. A planning call is the quickest way to get a realistic timeline for your estate