The University of Iowa Hospitals and Clinics was transitioning to the new Beaker LIS. In 2014 alone, they handled more than 32,000 in-patient admissions, 56,000 ER visits, and more than 914,300 clinic visits. It was therefore critical to maintain productivity and minimize the impact of any downtime during the switch. Roche Middleware played a central role. What the University of Iowa discovered was that middleware and LIS always work better together.