If trouble of any kind is detected, the system immediately sounds the alarm. “We’ll get a message — ‘The backup has failed’ or ‘Low on space’ — so we’ll call the client and find out what’s going on. It raises the level of awareness,” says Ott.
The cost for using WellCare? Zip. “We put it in place to prevent a forest fire,” Ott explains. “It’s free, but people are always skeptical of free, to a point where we even considered charging a little fee for it.”
Some of you may feel uncomfortable with allowing an outside party to handle your backup needs. After all, we’re talking about private patient data. “They’re suspicious that we’re monitoring their activities, bleeding data,” says Ott. But there’s no need to worry, he says. “We don’t actually have access to your system; it’s all event-driven. We react to messages your system sends.”
Ott says NextGen makes a tremendous effort to apprise its clients of WellCare’s capabilities. “We can’t make you do it, but we can make you aware and encourage you to do it.”
North Fulton Family Medicine takes advantage of its EMR vendor’s backup service, Healthmatics Secure, which is supported by Allscripts. “It’s the reason I can sleep well at night,” Morrow says. “Every hour, our data is backed up to a server in Austin, Texas. If we have a downtime where we can’t access the server, we can tap into the second server.”
The practice’s Alpharetta, Ga., office tends to lose power regularly owing to area construction. Morrow called the EMR vendor, Allscripts. “I said I didn’t want to alter data on the [secondary] server, but to be able to get information — sort of a read-only.”
Fifteen minutes later, the practice was up and running.
Still, you may choose to set up backup/recovery procedures yourself, particularly if you’re tech savvy.
SETMA established its backup plan a decade ago, before its EMR vendor, NextGen, offered WellCare. The practice is loath to retrofit its protocols, but not because NextGen’s solution is lacking. “We’ve done a lot of customization,” says Holly. “The Internet was not what it is today. Once you start on a course, it’s hard to change it.”
North Fulton Family Medicine outsourced its backup needs to an IT company until about three years ago. “When we finally got to the point where we were writing a check every month equal to what we would pay someone in-house, that’s when we went in-house,” says Morrow.
So what’s the plan?
Redundancy is key, says Ott. “When we do an implementation, we require — or at least strongly recommend — that you build redundancy with your implementation,” he says. “Computers are what they are, and you should build in redundancy to guard against failure.”
This means having a backup plan for your backup plan, such as a secondary server — preferably offsite — that holds what is essentially a mirror image of your live data. The routine backup procedures you set up in your office should write to this server on a regular basis.
And what’s “regular”? Something different for every practice. For SETMA, it means every 15 minutes. “The maximum [amount of data] we can lose is 14.5 minutes — fairly inconsequential,” says Holly. His practice also backs up the entire system twice a day to tapes, stashing them in a bank vault.
SETMA’s backup is asynchronous, meaning the data on the two servers are never exactly alike. Synchronous backup occurs when the system backs up every time a transaction is entered. Obviously, the more often you back up, the less data you stand to lose. However, synchronous backup slows down system performance, which is annoying to EMR users, and it’s quite expensive, which is annoying to whoever has to pay for it — probably you.
