20 steps to keep your practice running when the EHR goes down

When Change Healthcare went dark in 2024, the damage reached far beyond one clearinghouse. In an informal American Medical Association survey of more than 1,400 respondents, 80 percent said their practices lost revenue from unpaid claims and 85 percent had to throw extra staff time at revenue cycle tasks. That was a vendor problem. When it's your EHR that goes down, the schedule, the chart and the prescription pad disappear with it.

Outages aren't rare, and they aren't always short. In 2021, a reported ransomware attack on a hosting partner left some practices on the Aprima EHR locked out for more than two weeks. One endocrinologist told Healthcare IT News his downtime protocols were never designed for a 14-day outage. The HIPAA Security Rule already requires a data backup plan, a disaster recovery plan and an emergency mode operation plan. Plenty of practices have the binder. Far fewer could run a full clinic day without the EHR.

ONC's updated Contingency Planning SAFER Guide spells out what "ready" actually looks like, down to how many hours of paper forms to stock. Here are 20 places to start.