In recent news articles, the fragility of hospital EMR platforms has been illustrated by the interruption of access to the EMR and the resulting loss of information to clinical workers. In at least one case, the hospital was without access for a number of days, creating havoc and closing vital services. The backup plan in these cases is to go to paper forms but this means there is no access to existing information in many cases and the hospital is often thrown into chaos.
While we might all wish that these were isolated incidents, the reality is that hospital EMRs normally rely on the hospital’s internal network to be reliable. The network in turn relies on the IT staff to maintain the many complex elements of the system without making any major mistakes. While these systems will have some level of redundancy, at least for data storage devices, the networks themselves can be affected by a number of factors including hacking and sabotage that will take them off line. Recent news articles have also profiled hospitals that have been invaded by ransomware resulting in days to get back online and a cost of thousands of dollars to cure.
Cloud-based EMR vendors such as E-Health Records International, Inc., replicate databases across multiple data centers and leverage the cell phone network for alternate access. Because the cell system tends to be very robust even when there are power interruptions and landline problems, this provides a real-time backup that will bridge over problems with a hospital’s internal systems. As a mission-critical application, having redundancies at all levels of operations is the key to maintaining 100% up time and utilizing the cell network (which itself has many redundancies built in) is a way to do this.
In some of the Gulf Coast areas, backup systems also include satellite internet connectivity to allow connection during periods when local internet connections are not available. Satellite connections prove to be very reliable and can be a good backup for other internet connections.
Database replication in the cloud, such as with Amazon Web Services, can also serve to bridge when local systems fail. When internal systems fail, which they ultimately will, having options that continue access to patient data can be critical to keeping a hospital functioning. Reverting to paper should be the last resort after all other options are exhausted.