It's a nightmare any hospital hopes to avoid: a crash or prolonged outage of its central information system. As hospitals and health systems continue to transition to an all-electronic landscape, though, the possibility of an information system crash is just one unexpected disaster away from occurring.
Michael Ward, director of information services at Anderson Hospital in Maryville, Ill., gives four considerations to shore up a contingency plan in case a hospital's information system hits a snag.
1. Conduct risk assessment and risk value. The very first step any hospital needs to take for a potential information system crash is the determination of what health IT systems are most critical and absolutely need to be functional. Mr. Ward says these risk assessments and valuations help hospitals pinpoint which systems are risk-averse and which are risk-tolerant.
A risk-averse system is a system that is crucial and can't endure long periods of downtime, such as electronic health records, and other patient safety/quality systems. A risk-tolerant system is one that is important but not vital or urgent to patient safety, such as accounting systems, revenue cycle systems and education systems. "All hands are on deck to battle the clinical side, and then you start working on the financial side," Mr. Ward says.
2. Consider different types of backup systems. Once a hospital ascertains its hierarchy of most important systems, it must figure out how it will actually back up the main information system. Mr. Ward says many things need to be considered, such as how much bandwidth a hospital needs and, perhaps most importantly, how much money is willing to be spent. A hot site has all data from the systems in a remote location, and it is constantly on ready to go in case of any disaster — but it is also costly. A cold site is similar to a hot site except that is not constantly on and is typically less expensive, although data is still easily accessible for hospital officials.
3. Remain focused and ready to work if crash does occur. Anderson Hospital recently suffered an information system crash, and the system was down for more than 48 hours. However, Mr. Ward said hospital officials assembled a group to determine which information was critical to treat patients and, in their case, used a printer not hooked up to the network to retrieve essential patient information for immediate treatments. Hospital staff should know the risk assessment and contingency plans, he says. "If the whole building is destroyed, you still need to grab the data out for patients," Mr. Ward says. "You still need to process the billing and claims. Even though the hospital could be closed, you still have a lot more work to do."
4. Stay abreast of government incentives, regulations. Between the meaningful use incentives of the Health Information Technology for Economic and Clinical Health Act and the patient privacy issues within the Health Insurance Portability and Accountability Act, health IT is both here to stay and heavily scrutinized. Mr. Ward says with hospitals making the transition away from paper records, being able to back those systems up in case of a disaster is of utmost importance.
Instances where hospitals are torn apart by natural disasters, like what St. John's Regional Medical Center in Joplin, Mo., experienced, also reinforce the need for a backup system even more, he says. "As the regulation groups and government provide further mandates, the need for disaster preparedness is constantly increasing," Mr. Ward says. "Hospitals have to come up with a multitude of ways to reduce that time where information is not available to caregivers and decide how much money to put into disaster preparedness."
U.S. News: 24% of Hospital Executives Extremely Concerned About Costs of Full Transition to EMRs
Online Marketplace Allows Hospitals to Exchange Intellectual Property
Michael Ward, director of information services at Anderson Hospital in Maryville, Ill., gives four considerations to shore up a contingency plan in case a hospital's information system hits a snag.
1. Conduct risk assessment and risk value. The very first step any hospital needs to take for a potential information system crash is the determination of what health IT systems are most critical and absolutely need to be functional. Mr. Ward says these risk assessments and valuations help hospitals pinpoint which systems are risk-averse and which are risk-tolerant.
A risk-averse system is a system that is crucial and can't endure long periods of downtime, such as electronic health records, and other patient safety/quality systems. A risk-tolerant system is one that is important but not vital or urgent to patient safety, such as accounting systems, revenue cycle systems and education systems. "All hands are on deck to battle the clinical side, and then you start working on the financial side," Mr. Ward says.
2. Consider different types of backup systems. Once a hospital ascertains its hierarchy of most important systems, it must figure out how it will actually back up the main information system. Mr. Ward says many things need to be considered, such as how much bandwidth a hospital needs and, perhaps most importantly, how much money is willing to be spent. A hot site has all data from the systems in a remote location, and it is constantly on ready to go in case of any disaster — but it is also costly. A cold site is similar to a hot site except that is not constantly on and is typically less expensive, although data is still easily accessible for hospital officials.
3. Remain focused and ready to work if crash does occur. Anderson Hospital recently suffered an information system crash, and the system was down for more than 48 hours. However, Mr. Ward said hospital officials assembled a group to determine which information was critical to treat patients and, in their case, used a printer not hooked up to the network to retrieve essential patient information for immediate treatments. Hospital staff should know the risk assessment and contingency plans, he says. "If the whole building is destroyed, you still need to grab the data out for patients," Mr. Ward says. "You still need to process the billing and claims. Even though the hospital could be closed, you still have a lot more work to do."
4. Stay abreast of government incentives, regulations. Between the meaningful use incentives of the Health Information Technology for Economic and Clinical Health Act and the patient privacy issues within the Health Insurance Portability and Accountability Act, health IT is both here to stay and heavily scrutinized. Mr. Ward says with hospitals making the transition away from paper records, being able to back those systems up in case of a disaster is of utmost importance.
Instances where hospitals are torn apart by natural disasters, like what St. John's Regional Medical Center in Joplin, Mo., experienced, also reinforce the need for a backup system even more, he says. "As the regulation groups and government provide further mandates, the need for disaster preparedness is constantly increasing," Mr. Ward says. "Hospitals have to come up with a multitude of ways to reduce that time where information is not available to caregivers and decide how much money to put into disaster preparedness."
Related Articles on Hospital Health IT:
Mayo Clinic Constructs Pioneering Health Information ExchangeU.S. News: 24% of Hospital Executives Extremely Concerned About Costs of Full Transition to EMRs
Online Marketplace Allows Hospitals to Exchange Intellectual Property