Upgrade of system software is usually achieved by running update patches.

Excelicare is based on a client-server model, and many patches and minor upgrades are achieved by running an Update patch against each client. This patch is deployed via a centrally accessible server or on CD, and each client may be upgraded to a schedule, to allow continuous use of the Patient Record by some machines while others are being upgraded on a planned rotation. Major patches requiring upgrades to the database server will involve some level of server downtime. However these are infrequent and are handled via an installation program shipped by AxSys: a test is performed on a mirrored database by QA prior to updating the actual database, at which time the duration of down-time can be estimated prior to scheduling the actual upgrade. Exceliport interfaces are programmed to queue while the server is updated.