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Chapter 20

Health Information Systems: Downtime and Disaster Recovery

Introduction

The primary objective for downtime and disaster planning is to protect the organization and the patients who are served by that organization by minimizing the disruption to the operations.

Downtime Risk Assessment

Should occur from project inception through system maturity.

Downtimes can be classified by the root cause and the degree of impact.

Root cause must be determined.

Priority will be unique for each organization.

Information technology (IT) should work closely with the organization’s emergency preparedness and disaster planning groups.

Sample Elements of Information Technology Infrastructure

Box 18-1 from text

Examples of Information Technology Physical Structure

Box 18-2 from text.

Downtime and Response Planning

Consider both planned and unplanned downtimes.

Develop the response and recovery plans.

Quick assessment of the significance of a downtime event will help determine a response.

Downtime Determinator Model

Figure 18-2 from text.

Clinical Impact and Planning

Clinical impact and planning: Acute care focus

Types of back-up systems

Downtime policies and procedures

Redundant Systems

Are also known as back-up systems.

Provide the clinicians with the ability to access some, if not all, of the patient’s data during an electronic downtime.

Some systems cannot be updated during a downtime.

Shadow or mirror systems often have read and write capabilities.

Web-based systems are used for planned downtimes.

Downtime Policies and Procedures

Guide the clinical team.

Should include specific instructions about required data entry back into the legal and permanent electronic health records (EHRs) systems at the conclusion of the downtime.

Information Technology—Impact and Planning

Assessment risk

Is a service management program needed?

What is the service management life cycle?

Disaster plan

What are its contents?

Who needs to be involved?

Are the test plans up to date?

Disaster Planning

Must be compliant with the Health Insurance Portability and Accountability Act (HIPAA) security rule of 1996, the Department of Health and Human Services, and The Joint Commission (TJC).

Organization needs to be prepared to rapidly test the clinical system to ensure that all aspects of the system are functioning as planned.

Disaster Recovery

Determine and prioritize critical systems.

Plan to get the systems back on line.

Business Continuity

Include the systems that run the business.

Formal process includes:

Impact analysis

Recovery strategies

Formal plan

Testing of the plan

Communication

Communication plan

Who needs to know?

What details do they need?

Who will communicate the details to those who need to know?

What systems and workflows are affected?

Responsibilities

Communicate the necessary information to the following:

Desk agents

Senior leadership

Public relations personnel

Other (e.g., university affiliations, community)

Conclusion and Future Directions

Downtime and disaster recovery is necessary to:

Minimize the economic loss.

Ensure organizational stability.

Protect the critical assets of the organization.

Ensure the safety of personnel.

Protect patients and other customers.

Reduce the variability in decision making during a disaster.

Minimize legal liability.

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