Without question, electronic health record (EHR) technology has evolved how standard medical practice functions. EHR implementation brings so many advantages, including enhanced efficiency, improved patient experience, and cost reductions. As of 2021, almost 90 percent of office-based medical care providers were using EHR software within their practices due to the obvious advantages.
As advantageous as EHR software is, EHR downtime can be detrimental to a practice. Therefore, having adequate EHR downtime procedures and plans in place is critical. Find out what your practice can do to prepare for unplanned downtime, how to prevent outages, and more below.
How to Prepare for EHR Downtime
1. Be prepared for EHR downtime
The best thing your practice can do to prepare for EHR downtime is to make plans for when or if EHR usability is not possible. Unplanned downtime can set in motion a long list of problems. For example, in 2012, the Boulder Community Hospital’s EHR software malfunctioned, and the hospital had no structured plan in place. Therefore, patient data was mostly inaccessible for 10 days. This led to everything from longer-then-necessary wait times for patients to slowed response times from staff.
There are a number of steps an organization can take to get prepared before a system failure, such as:
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- Making sure printed patient data is accessible
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- Ensuring staff members know how to handle manual documentation
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- Creating a comprehensive plan for EHR system failures
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- Understanding what steps the EHR company can take during a malfunction to help
2. Train for downtime from the beginning
Training staff members on EHR downtime should be just as important as training for EHR downtime. The best plan is to make downtime training a part of the initial software training program. The organization should also have easy-to-access documents and guides in paper form that let them know how to react in the event the EHR system goes down.
Make sure staff members know things like how to:
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- Find and use paper charts
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- Document incoming patient information
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- Use paper documentation to create important things like medication and allergy forms
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- Choose what types of service offerings can be delayed safely
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- How to use traditional paper prescription protocols
3. Create an incidence response downtime plan
Be sure to implement an incident response downtime plan for electronic health records. Patient records must be accessible even when the EHR system is non-functional. Otherwise, this could mean patient safety is at risk.
A good example of how a lack of incident response plans could be an issue when EHR downtime occurs comes from a study published in Applied Clinical Informatics in 2019. Researchers found that during EMR downtime, results from lab testing in a hospital were delayed by roughly 62 percent longer than usual. This severe delay was said to be partially related to the inadequate execution of procedures and downtime paper records that were inconsistent. These slowed lab results in a hospital setting could easily mean a delayed diagnosis, which could put a patient at risk.
4. Practice for an outage
Documented plans are important during EHR downtime, but the best way to ensure patient safety and organizational efficiency is to practice. Set aside a designated time point and run through a practice drill to determine if all staff members know how to respond when the EHR system is not accessible. These practice runs can pinpoint critical areas that need to be addressed.
Sometimes, small things can be overlooked during planning that would become obvious during a practice drill. For instance, you may realize that the arm bracelets used during patient admissions cannot be written on, or you don’t have paper sign-in sheets available. However, stimulated outages can also reveal major gaps in training or how certain tasks must be modified.
5. Designate a person to document during EHR downtime
Great potential for error exists when an EHR is offline. Much of this error is related to improper information documentation. In one instance covered by the Institute for Safe Medication Practices, a pediatric patient was given double the dose of epinephrine because the EHR’s medication administration record for the patient was not available. This could have been avoided by having a designated individual to document medications given during the scheduled EHR downtime.
6. Run backups and store backups in different locations
Make sure EHR data is stored on different servers. In the aforementioned case affecting Boulder Community Hospital, the EHR malfunction affected the main server and a backup server. Therefore, it is best to have backups in place in multiple places.
7. Know who to contact in the event of a data breach
EHR downtime can be caused by a host of issues, but one of those issues is malicious software that can lead to a data breach. If an outage is caused by a data breach, it will be imperative that you contact the relevant authorities immediately. The authorities often have systems in place and IT specialists that can step in to negate as much damage as possible.
Policies and Procedures to Prevent Future Outages
As noted above, EHR downtime can occur due to a number of reasons. The top reasons include:
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- Software failures
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- Malicious software or computer viruses
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- Internet connectivity issues
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- Power failures
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- Outdated technology infrastructures
While there are some causes that are often beyond control, many causes are directly within an organization’s control. For example, failing to switch EHR when the system repeatedly has issues with failure or lacks technology support, could directly contribute to a prolonged outage.
Building a plan to prevent future outages may involve making changes to technology, building a more robust antivirus program, or even investing in secondary internet services. Whatever the required changes may be, these investments should be considered an investment in operational capability and patient safety.
A Final Word on Avoiding EHR Downtime with the Best EHR Software
The top EHR software providers go the extra mile to ensure downtime is manageable and avoidable. PrognoCIS EHR is designed with your organization in mind, which means unplanned downtime can be avoided as much as possible. Reach out to schedule a demo if you feel it is time to switch EHR technology.
