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What would you do if an EMR goes down?

Remember the news about an EMR outage at Fletcher Allen Health Care in Burlington, Vt., from August? A new, $57 million installation was rendered useless for hours following a power loss and subsequent failure of battery backups. Fortunately, the health system had a plan in place to revert to paper records during the unscheduled downtime. "This went smoothly because our staff still remembered how to document and write orders on paper, as it hadn't been that long since we'd gone electronic," Chief Nursing Officer Sandra Dalton says in a For The Record feature story on dealing with EMR and EHR downtime.

In the future, facilities might not be so lucky, since new clinicians are training on electronic systems and won't be used to paper documentation. "If the downtime policy requires going back to paper records and that method doesn't mirror how it was done on the EHR system, then they're going to be lost. That's why it's important to be constantly refreshing staff on this method," according to Slippery Rock (Pa.) University nursing professor Debra M. Wolf.

Wolf says it may not be a bad idea to have multiple levels of contingency plans to address the significance of an outage. "A level 1 downtime might mean that part of the system is down, but the majority of the content is still accessible. Level 2 might be that the majority of the content is unavailable. And level 3 could mean that you have absolutely no access to the system," she tells the magazine. In all cases, it's critically important to develop response strategies, educate staff and to have a method of communication available when a contingency plan goes into effect.

For more information on surviving unplanned outages:
- read this For The Record story

Related Articles:
EMR fails following power outage at VT hospital
Study: Dual EMR-paper systems may exacerbate communication problem

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Beyond simply ordering tests and charting is the question of actually getting things done in a timely manner. In EHR dependent systems getting labs, imaging and even ordering meds can be significantly delayed with potential catastrophic impact on patients. Then there is the question who inputs all the data once the system comes back up. In an outage of more than a couple hours the task can be become monumental and beyond the ability of individual clinical staff to accomplish.

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