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How to survive an EHR outage


Most physicians have plans for responding to computer system failures, but many don’t revisit those disaster recovery/business continuity plans with any regularity.

Most physicians have plans for responding to computer system failures, but many don’t revisit those disaster recovery/business continuity plans with any regularity.

The reliability of computer systems is much higher now than it used to be, but failures still occur-whether they stem from short-term power outages, lost internet connections or crippling malware attacks. And with more than 80% of physicians using computers, an electronic health record (EHR) system that goes down could bring a practice to a screeching halt.

“It is really incumbent on small physician practices to understand what it takes to keep the business running in case of a disaster,” says Michael McCoy, MD, chief executive officer of the consulting firm Physician Technology Services Inc.

Develop a recovery plan, and revisit it

Develop a plan and revisit it on a regular schedule to ensure it adequately addresses the latest additions and updates to your EHR system as well as the ancillary computer systems that connect to it, McCoy says. He adds that it’s worthwhile to work with a consultant who specializes in disaster recovery and business continuity planning.

Practice those plans

Diligent practices might think they’re prepared simply because they have a disaster recovery plan and are taking  proactive steps, such as backing up EHR files. But medical offices that suffer an extended outage often find they’re not able to cope due to lack of practical experience and/or problems in their plans, McCoy says. Drills will not only give staff that practical experience, they will reveal any unforeseen problems, such as corrupted backup files.


Coordinate with your EHR vendor

Restoring patient records is only part of what’s needed following an EHR system failure. The other important piece is restoring the actual application with all the updates and patches that have come through since it was first installed, health IT experts say. “You have to have the ability to restore a valid, non-corrupt back up,”
McCoy explains.

Don’t assume the cloud is foolproof

Cloud providers generally offer higher levels of redundancy and cybersecurity than any individual practice can muster, but health IT experts note that a cloud-based EHR is still vulnerable to outages. “They still have hardware issues; they have software issues,” McCoy says.

Physicians with a cloud-based EHR still need to have disaster recovery and business continuity plans in place, and those plans could include backing up of patient records beyond what the cloud vendor provides.

Know how to transition back to the electronic system

Disaster recovery plans should-but often don’t-include strategies for transitioning back to restored computer systems, says Thomas Payne, MD, FACP, medical director of IT services at University of Washington School of Medicine and board chairman for the American Medical Informatics Association. “Oftentimes when systems are down, physicians use paper and then the question is, how much of that record should be entered back in,” he explains. It’s better to map out in advance what data should go back into the electronic records, who will handle that work and at what cost. 

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