Migrate from PracticeHub to Twenty CRM

PracticeHub's 1 req/sec API rate limit gates extraction speed for large datasets

PracticeHub enforces a hard rate limit of 1 API request per second per account. This is not a soft throttle — exceeding it returns errors. For a migration involving 50,000 patient records with appointment histories, extraction alone takes approximately 14 hours of API polling before a single record lands in Twenty. FlitStack staggers all requests with 1.05-second intervals to stay compliant. If PracticeHub publishes bulk export endpoints, we use those instead, but the rate limit applies to every HTTP request against the PracticeHub API regardless of endpoint. Teams should plan for extraction windows that run overnight or over weekends for large datasets, and should not schedule the migration cutover assuming the source API can be queried in parallel at high speed.

Twenty requires custom fields to be pre-created before CSV import — import does not auto-create fields

Twenty's CSV import process creates records, not fields. If a column in your import CSV references a field that does not exist in Twenty's data model, the import silently drops that column or errors out depending on the field type. FlitStack generates a complete field pre-creation checklist as part of the migration plan: for each PracticeHub custom property, we specify the target object, field type (text, select, multi-select, date, number, relation), and exact field name to create in Settings → Data Model. We recommend creating all custom fields in Twenty before the first import run. If fields are missing at import time, the import can be re-run after fields are created, but records already imported will not auto-update — a second pass is required.

Twenty's import order dependency requires Companies before People before Opportunities

Twenty's CSV import enforces referential integrity at import time. A People record that references a companyId must have that Company already present in Twenty — otherwise the import rejects the row or sets companyId to null. PracticeHub exports objects individually, so the natural export order from PracticeHub may not match the required import order for Twenty. FlitStack re-structures all CSV exports into the correct sequence: Companies first (with their domain and name fields), then People with resolved companyId references, then Opportunities with their companyId and personId lookups, then custom objects last. If your PracticeHub data has circular references (a person record references a company that itself has no explicit record), we create a placeholder Company or flag for manual resolution before proceeding.

Twenty's uniqueness constraint can restore soft-deleted records on import

Twenty's import process treats email addresses and other unique field values as hard uniqueness constraints. If a record with the same email already exists in Twenty — including records that were soft-deleted and are visible under Command Menu → See deleted records — importing a duplicate will either fail or restore the deleted record depending on the import configuration. This catches teams off guard when migrating from PracticeHub after previous partial migrations or test imports. FlitStack pre-scans both PracticeHub and Twenty for duplicate email addresses before the migration run. Any conflicts are surfaced in the migration plan with a choice: delete the existing Twenty record, merge the data, or skip the PracticeHub record.

Healthcare compliance data must be handled as custom fields with restricted access

PracticeHub stores clinical and compliance data (treatment plans, medical history, referral sources, insurance details) that may constitute Protected Health Information under applicable regulations. Twenty CRM is a general-purpose CRM with no built-in HIPAA compliance model. Clinical fields migrating from PracticeHub land as custom fields on People or custom objects in Twenty, visible to any Twenty user with record access. Before migration, your team must decide which fields to migrate (and under what access controls), which to exclude, and whether a separate compliant storage layer is needed for the most sensitive records. FlitStack migrates the data you specify; access control configuration is a post-migration setup step handled by your Twenty admin.