My previous post about the cost of EHR down time prompted me to think of all the ways that your EHR can go down. This might not be an exhaustive list, but hopefully it gives you an idea of the many many ways that your EMR can go down. With that knowledge hopefully you’ll be inspired to plan for EMR down time.
Reasons Your EMR Could Go Down:
Power Outage – Very few EMRs are setup to be able to handle a power outage. Sure, maybe you have a UPS attached to your server and some battery life in your laptop, but that’s only going to last so long. Plus, I bet your router/network switch isn’t on a UPS. What about your printer? You get the idea. EMR and power are friends.
Hard Drive Failure – At some point I asked someone why it was so common for hard drives to crash. They then described that hard drives are moving parts and anytime something is moving, there’s a higher chance that something will go wrong. Of course, now they have solid state hard drives that you can get. Either way, I’ve seen a lot of hard drives fail in my time. Of course, if you have a nice RAID setup for your hard drives, then you often won’t notice. Until they have to replace the failed hard drive with a new one. This could be the hard drive of your server or your computer. Most computers don’t have a RAID configuration.
Power Supply Failure – Most servers have redundant power supply. Why? Because they’ve been known to fail. If your server doesn’t have a redundant power supply, then be ready for down time. Most desktops don’t have redundant power supply and so they could easily fail too.
Network Cable – I don’t think I’ve ever seen a network cable go bad. However, I’ve certainly seen plenty of cables to servers bumped, moved, ripped out of the server. Everyone wonders why the server went down. Takes far too long to see that the network cable just got pulled out a little too much.
Switch/Router – Switches and Routers are what’s used in most offices to connect all your computers to the internet. Certainly these can go down if the power goes out. However, they can have other issues too. It’s not that common, but can sometimes cause down time for your office. Of course, wirelesss routers in particular can cause clinics lots of headaches when they go down.
Motherboard Failure – Might as well cover another common hardware failure: the motherboard. No motherboard and you can’t use your EMR.
EHR Software Issue – I’ve seen where a poorly tested and implemented EMR system would slowly use up all the memory on a server. Once it used up all the memory on the server, the EMR would take forever to do the simplest task. While not technically down since the server is up, it’s still a form of down time since users start refusing to use it in this state.
Internet Outage – This is particularly applicable to a SaaS EHR. Unless you have spent a lot of money to get redundant internet lines to your office (which in some locations is impossible), your internet will go down sooner or later. I don’t know how many times I’ve heard of some construction guy digging up the internet lines and causing outages for doctors offices. Happens all the time.
Much of the above can be applied to servers, desktops or laptops. Sometimes it causes a partial outage (ie. one laptop dies). Other times it takes down your whole EMR system (server dies). Either way, you should consider all these possibilities. Then, you see how you can minimize them (likely with the help of your IT support). Then, you think about what you’re going to do when the EMR down time happens.
Speaking from first hand experience, having a plan for EMR down time made all the difference when the event occurred.