Electronic health record downtime responses : One health system's process for ongoing readiness

Since the implementation of the HITECH Act 2009, the integration of the electronic health record (EHR) with other technology platforms has increased the complexity and necessity of technology downtimes, and the continuity of patient care has become increasingly dependent on an intact EHR. To maintain business continuity and safe patient care during planned or unplanned EHR downtime, it is imperative that organisations have solid downtime and disaster recovery plans. Successful downtime planning will include documenting, with annual reviews, the process for patient care during downtime, as well as an exercise programme that touches all aspects of the downtime process. This paper discusses the experience of a healthcare system based in the US Midwest, which has chosen to exercise part of that process on a quarterly basis, prior to scheduled EHR upgrades. Over the past year of exercises, this healthcare system has collected various data elements in order to identify the education needed and the fine-tuning of the exercise design required to ensure staff competency and patient safety during EHR downtime. The paper describes the process, outcome and the steps the organisation is taking to improve the outcomes of future EHR downtimes.