Friday, June 07, 2013

A Useful Reminder Of The Need To Be Able To Restore Data After Disaster And Problems.

This appeared a few days ago.

Backup plans for EHR failures need regular testing

Regardless of whether the system is local or cloud-based, physician practices should have a plan that includes off-site storage of data.

By Pamela Lewis Dolan — Posted May 27, 2013.
Any practice using an electronic health records system must assume that the software, or the equipment it operates on, at some point will suffer a glitch or be at risk of damage in a natural disaster. That’s why experts say it’s important that practices take steps to ensure data backup is being done properly, even if the task is handled by outside parties. The practice also should know how it can restore its data in the event of a system failure.
A practice’s backup plan should include not just the ability to retrieve data, but also the time it takes to retrieve it, said Bob Dupuis, director of managed services at Arcadia Solutions, a health care consulting firm in Burlington, Mass. Because machines can malfunction as easily as software, a backup plan and testing should include the hardware on which the data are run or stored.
There are many strategies of backing up data that can be done in-house, in the cloud or a combination of both. A backup plan often comes as part of the EHR package, especially those that are cloud-based, but the backup plans can extend beyond what the vendor offers if a practice contracts with a third party for that service. Experts say practices that have systems hosted by a server inside the practice should have a backup plan that includes off-site storage of data either in a physical location or in the cloud.
The riskiest plan would be to keep all the data and the backups in the same location, said Robert King, founder and president of EntelliProj Consulting, a management consulting firm in Maple Shade, N.J.
The goal of a backup plan is to get the most amount of data restored in the least amount of time. Some systems back up data incrementally by saving only changes made to the database on a daily basis, with a full backup occurring once a week or a longer interval. Systems vary in terms of how quickly they can restore the data to the last backup that occurred. Practices should determine the value of a day’s, week’s or months’ worth of data, and the maximum time it could revert to paper without severe consequences. The sophistication of the backup plan can be chosen based on this criteria.
Lots more here:
These points and the ones that follow were made even more apt by this report.

EHRs critical in Oklahoma tornado

By Kaiser Health News
By Jenny Gold
Everyone expects a hospital to be ready to jump into action when disaster strikes. But what about when the disaster devastates the hospital itself?
Turns out, it helps a lot to have an electronic medical record system in place.
At least that was the case at Moore Medical Center in Oklahoma, a small hospital right in the path of the tornado that ripped through the suburbs of Oklahoma City on Monday. Three-hundred people — staff, patients and community members — hunkered down in the cafeteria, stairwells and chapel as 200-miles-per-hour winds demolished the building around them.
One patient in labor stayed on the second floor with two nurses, where they could continue to monitor the fetal heartbeat.
Amazingly, everyone survived. Within an hour, 30 patients had been transferred to the two other hospitals that are part of the Norman Regional Health System. And every one of them arrived with their medical histories fully intact. The woman in labor even delivered a healthy baby later that evening.
“The transfer was totally seamless,” says John Meharg, director of health information technology at Norman, which has had an electronic health record system for the past five years. “We’re very fortunate that we’re a little ahead of the game,” he said.
Lots more here:
Here we see that as long as the data centre and connectivity can be preserved good things will happen even if locally a disaster has happened.
There is a message for all those who don’t make sure regular backups are taken off site - just taking a backup home from the surgery once a week would make a huge difference if disaster strikes at the surgery. Testing for restore capability regularly is also vital.
See here for RACGP recommendations - point 5 gets most of the detail.
On a similar topic the College points out that Window’s XP only has about 10 months of support left - so plans of what to do after that need to be initiated.
See here:
This seems to be a very sensible list:
“The RACGP recommends that practices currently running on Microsoft Windows XP consider upgrading their operating system now and follow this suggested checklist:
  1. Conduct a stocktake of your computers, including documenting the specifications and age of each computer and how many are running on Windows XP.
  2. Determine how many computers might need upgrading or replacing to meet the minimum specifications for running the practice clinical and management software.
  3. Consider whether upgrading to new computers would be a better option in terms of long term maintenance costs and practice disruption.
  4. Consider which operating system might be best suited for the practices requirements (Windows 7, 8 or Apple).
  5. Develop an upgrade plan for your practice based on budget and capacity. Eg. one new computer per month or a bulk purchase.
  6. Consider how best to dispose of old computers and hard drives, consult the RACGP’s Effective solutions for e-waste in your practice.”

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