Preparing for Disaster
The late Summer and early Fall of 2017 will likely be remembered as the one where Mother Nature unleashed three of the most powerful, devastating hurricanes on record, leaving wide paths of destruction. While watching the images of flooded homes and wind-shorn buildings, most of us have likely pondered how we’d handle similar situations – and whether or not we’d be prepared if a natural disaster came our way.
When Hurricane Katrina hit in 2005, only about 25% of providers had EHRs, compared to about 75% today. During those early days of recovery, patients and clinicians scrambled to confirm medication histories and other relevant details after thousands of paper records were swept away or otherwise ruined.
During a natural disaster, several occurrences may arise that can impact patient safety. The physical location of a hospital or medical practice may be compromised and there could be a loss of power. Access to medical records may be limited, if available at all, limiting the knowledge providers have about a person’s medical history, current medications and treatment plans and much more. All of these factors can jeopardize proper patient care at a time when there are more people who need treatment.
The increase in EHR adoption, a move towards more cloud based computing and record-sharing between providers also means that floods, earthquakes, fires and other types of disasters rarely result in a total loss of medical records. However, rather than assume you are safe from data loss, we recommend that you verify your readiness – especially if you maintain your own server and backups. The best time to make sure you’re prepared for a natural disaster is when things are calm – and not when the next big storm is on track to hit your location.
Where to start
Not sure how to assess your practice’s readiness to survive a disaster – natural or manmade –with all your EHR data intact? Here are some tips to get your started.
Whether your EHR is deployed on a server in your office or hosted off-site, schedule a conversation with the professionals who are responsible for your IT services and connectivity. Begin by asking these important questions:
- Do you have a backup plan in place for your EHR? If you don’t, NOW is the time to do so!
- If you do have a plan in place, what are the specifics of the plan?
- Is your data backed up daily?
- If not, what is the frequency of the backup?
- Who is responsible for performing that task?
- Where is the backup data stored?
- What specific data is backed up and what is not?
- If your data is not stored securely off site, what steps need to be taken to add that to your plan to ensure your backup remains safe during a disaster?
- Have you tested the backup process to make sure you are getting the data you need and that it can be restored if necessary?
If you have a server in your office and are lucky enough to have advanced warning that your office may be in jeopardy for some reason, consider removing the server and any backups to a safe, HIPAA-compliant, secure location. To be extra cautious, take the server to one location and the backup to another.
Make sure your IT team has tested the backup process and is confident that your system can be properly restored. Ideally you want a solution that quickly restores user access to your data with no loss of information and minimal downtime.
Finally, don’t forget about your devices, whether they are desktop PCs or mobile devices such as laptops, iPads, or other tablets. They need to not only be secure and safe but also able to connect to a new/temporary server quickly and easily.
If your data is being hosted remotely, be sure to verify that the hosting company is adhering to best practices and can verify that backup processes are working correctly. After all, one of the primary reasons that practices opt for a hosted solution is for the simplicity of a turnkey deployment. Even so, it should be mandatory to have something in writing that details your hosting company’s backup and disaster recovery plans, as well as an ongoing testing procedure that actually verifies it works. Remember, “an ounce of prevention is worth a pound of cure.”
Other healthcare services
Even if you have the ability to prescribe or order tests and services, other healthcare facilities might not have power or be operating. We saw this issue in Houston after Hurricane Harvey where pharmacies weren’t online and although they could receive medication requests from providers, they could not be dispensed. So make sure you find out what other medical services in the area are available to you should your primary resources be non-operational.
If you still have power
After Hurricanes Harvey, Irma and Maria, many medical facilities were closed for several days because flooded roadways, downed power lines, etc. made it impossible for practices to open their doors to patients. In some cases, even though practices were closed, staff could still access their EHR data, either because the server was located at an unaffected hosting center, or the practice’s own office still had power.
If a practice can access its server remotely, users have several options for accessing EHR data. As long as Internet access is still available, users can connect to the server from a remote laptop or PC and have the same functionality as users in the office. Alternatively, clients with Aprima Mobile loaded on an Apple or Android-based smartphone or tablet have the ability to perform such tasks as reviewing patients’ complete medical histories, approving lab results, writing prescriptions, viewing and managing appointments, or capturing patient charges.
Patients and providers with power and Internet connectivity can also access the Aprima Patient Portal. This allows patients, providers and practice staff to securely communicate from their computers or mobile devices. The Aprima Patient Portal also gives patients the ability to view their own medical data, including medication histories, as well as schedule appointments and make online payments.
If you lose power
Power outages are common when there is a natural disaster. You may have a battery backup that allows you to use your in-house system for a short amount of time or a generator if the power is out for several days. If your practice loses power and you have your data hosted remotely, you should be able to access your EHR, assuming there is Internet access at your location.
Day-to-day, we rarely give much thought to natural disasters and how they may impact our practice and understanding your practice’s backup process is a crucial component of your disaster recovery plan. However, by being prepared for the worst, practices can minimize potential disruptions and return to patient care sooner.