Shortly after 3 a.m. on Sept. 24, 2005, Hurricane Rita’s 20-mile-wide evil eye hit the coastline at the Texas and Louisiana border, killing 120 people, wiping 100,000 homes off the map, and uprooting 1.5 million trees.
“For the first time in my adult life, I experienced fear,” admits James Holly, a family physician and chief executive of Southeast Texas Medical Associates, or SETMA. “I’m accustomed to changing things, fixing things. But with this, there was nothing I could do.”
True, he could do nothing about the storm. Nevertheless, he and his 23-physician practice were prepared to deal with just such a catastrophic event. Only four days after the storm, SETMA reopened its Beaumont, Texas, clinic, and it had the EMR operating later the same week.
Not that there were many takers. Ninety-four percent of the greater Beaumont residents had evacuated. “We were so proud of ourselves because we were open, and I think we saw eight people,” he says, chuckling.
Although the survival of patient records may seem relatively inconsequential to the general public in the aftermath of a fatal storm, doctors know better. Accurate and accessible records are critical to the health of your patients and your practice. It doesn’t take an historic hurricane to wipe out your EMR, either. Virus attacks, power outages, hardware or software failures, and human errors are all powerful enough to bring your practice to its knees.
If disaster strikes, a clear recovery plan will make the critical difference between bouncing back and jeopardizing everything you’ve worked for. Are you prepared?
Failure to plan
At an absolute minimum, doctors should be backing up data on tape, which is the most common method. Back-up tapes should be taken offsite for storage — to a bank vault, for example. Storing tapes at home can save you time, but a storm could claim your office and home in one fell swoop.
Not surprisingly, taping isn’t foolproof. The tape itself could fail when you need it, says James Morrow, a family physician with North Fulton Family Medicine, a four-clinic practice in the Atlanta area. Tapes are at risk for accidental deactivation. They can be lost. Or there can be a recording failure. “[Practices] often use VHS. But then when they put in the tape, they’ve got ‘The Young and the Restless,’” Morrow says. “There should be a fire siren going off in the server room if something goes wrong, like a backup failed.”
David Ott, vice president of technical services for EMR vendor NextGen, concurs: “We had one customer who was in the process of upgrading. It turned out they had not had a successful [backup] for a year. They thought they were backing up every day, but were actually backing up the same file every day.”
Other lapses can result in disaster, too. North Fulton’s practice leaders learned this the hard way. “When we got infected with the Klez virus in 2002,” Morrow says, “we were under the impression that [our vendor was] maintaining virus protection, and they were under the impression that they were not.”
The group couldn’t prove anything. “We didn’t have it in writing, so we just had to suffer through the old ‘he said/she said.’”
North Fulton had to manually enter about 500 patient visits, replace the server, pay staff overtime, and endure nearly three full days of downtime. Total cost? About $25,000. “That was the impetus to change,” he says.
Who should do the backing up?
Your EMR vendor probably offers disaster recovery, perhaps through a third party. For example, NextGen offers its WellCare program through Silverback Technology. WellCare responds to disk crashes, ensures successful data backup, scrutinizes computer use to guard against virus attacks, and constantly scans and reports on the server’s status.
