Blog: Redundancy–Sandy's lesson for health IT

I had an opportunity last week to speak with a number of folks caught in the middle of dealing with Hurricane Sandy.

Not to go all Nietzsche on you, but what doesn't kill you at least gives you the opportunity to take some pride in being resilient—and maybe, if you're into healthcare IT, to figure out whether your disaster plan was adequate, and if not, how to do things better next time. And, oh yes, when facing disaster, be sure to keep a couple of reams of paper and a few old folks on hand.

Dr. Richard Schreiber and the staff at 290-bed Holy Spirit Hospital in Camp Hill, Penn., showed resilience when their remote-hosted EHR conked out on the evening of Oct. 29 after Sandy plowed into New Jersey where two of his vendor's main data centers are located.

As a result, the main EHR at Schreiber's hospital stayed off until about noon Tuesday.

But did Schreiber bash the vendor, Allscripts? Nope.

"They had their servers in New Jersey and New Jersey got clobbered," he said. "Can you plan for that? Well, they tried."

Schreiber and his fellow staffers just soldiered ahead using paper and pieced-together ancillary computer systems on local servers just as they do every month or so when they perform routine maintenance on the main EHR or do a systems upgrade. They had to stay with paper last week longer than they normally do, but they took it in stride.

"In this case, it was an external event," Schreiber said. "It wasn't just not our fault; it was nobody's fault. It was just a natural disaster. So let's just be adults."

Twin-campus 228-bed St. Luke's Cornwall Hospital in Newburgh and Cornwall, New York, some 50 miles up the Hudson River from the Big Apple, had a few windows broken and the neighbors lost a few trees, Cletis Earle, the hospitals' vice president and CIO told me. But both of Earle's hospitals kept their EHRs running and stayed connected, even though one went on a backup generator for a while.

"What I would like to consider right now is the statement: redundancy, redundancy, redundancy," Earle said. "If you have a network, have multiple carriers. Have co-location sites, both internally and off-site. You can mitigate the risk as much as possible. You prepare as much as you can, but always have paper on hand."

Fellow Modern Healthcare reporter Joe Carlson spoke last week with Dr. Sachin Shah, medical director of emergency medicine for 267-bed Nyack (N.Y.) Hospital, just across the Hudson River and 20 maybe miles north of the Bronx. Joe was telling me about Shah's vision of the future.

Shah told Joe that Nyack Hospital had connectivity issues, too. The hospital was forced off its EHR system and went back for a time to paper records. Fortunately, he said, there were still some people around who could use them—without needing an online tutorial.

But Shaw wondered aloud to my colleague what might happen when that is no longer so.

"In this type of situation, when you are so reliant on IT, you have to have backup plans, and it will be interesting to see in the future what will happen," Shah said.

He advised hospital leaders to teach their younger staffers how to use paper records, just in case.

Now, that's a milestone.



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