Health systems may increase the number of acute care centers either by new construction or acquisition. Significant planning is required just for the opening and integration of the new locations. Opening a new hospital and transitioning to a new electronic health record are significant projects that, even when taken separately, require substantial organization and coordination across a health system’s many departments. But what happens if you complete both within five days of each other? This presentation will share the planning beforehand, and the subsequent lessons learned following a successful new hospital opening and eHR implementation, transforming a single academic health center into a system of six hospitals. Strategies for instituting systemwide policies and establishing a single medication formulary will be shared, as well as plans for ongoing clinical governance.