January 9, 2006

Electronic medical records provide invaluable DR features

Girish Kumar
Hurricanes, tornadoes, earthquakes, fires, electrical outages, terrorism—these disasters can have an immediate and lasting impact on medical practices and their patients. More and more doctors are realizing that electronic medical records (EMR) optimize operations, reduce costs and improve care, while serving as an invaluable disaster recovery solution. In fact, the backup and recovery of data from EMR solutions can make the difference in saving medical practices and patient lives.

According to government studies, two out of five companies that experience disasters go out of business within five years. If disaster strikes a medical practice, the practice administrator must make sure that business continues in an efficient manner. Downtime means delayed or inaccessible medical records, impacting patient safety and satisfaction, as well as the practice's reputation. Decreased revenue and productivity are additional negative results. Another driver: HIPAA mandates contingency plans for practice disasters including backup, storage and recovery.

Mini case study
Consider for example Dr. Scott Needle, whose pediatrics practice in Bay St. Louis, Mississippi, was ruined by Hurricane Katrina. The town was devastated. Dr. Needle was forced to move his family north to stay with relatives. Though his offices were destroyed and his patients scattered, he was quickly able to reestablish his practice through his EMR system by accessing patient records. His story contains valuable lessons for medical practitioners.

Dr. Needle's EMR system provided access to patient records, history, prescriptions, lab and other test results. Because of the system's backup, remote storage and recovery capabilities, his data was easily recovered.
He recovered the data in his entire EMR system by saving the application on his Tablet PC before he evacuated. With the start of the school year just around the corner, his patients needed their children's medical and immunization records. He accessed the data for patients who are now scattered across the whole country. "I can't imagine if I was still using paper records," says Needle. "The files would have been lost or destroyed in the hurricane."

While the doctor retains his critical medical records, his office and computer hardware were flooded beyond recovery. However, demonstrating the flexibility of his EMR solution, he used mobile trailers with broadband Internet from nearby Hancock Medical Center to quickly set up a new technology infrastructure for his EMR data.

Key EMR features
Disaster recovery, streamlined workflow, increased doctor efficiency, clinical data collection and decision support are all one side of the EMR coin. On the other side, while reducing transcription and staff costs is helpful, a truly valuable EMR also addresses coding, reimbursement management and payor interactions to help drive practice profitability.

Many EMR vendors guarantee that critical patient information is safe. In one scheme, data is transmitted over a secure network using 128-bit encryption and is stored on fault-tolerant, fully redundant computers at secure locations. In case of hardware failure, users can access and update EMR data through a secure Web address accessible from any computer with Internet access. After an emergency, all EMR data, as well as any database activity performed in the interim, is fully restored to the practice's server without client interaction.

Designing a disaster recovery plan
The first step in designing a disaster recovery plan is performing a business impact analysis. This addresses the value of technology applications and data, the amount of disruption different event scenarios may cause, and the possible impact of such disruptions. This analysis makes it possible determine the nature of disaster recovery solution required.

For the most critical data, practices should consider an EMR solution that provides replication and remote storage to ensure accessibility, quick recovery time and minimal data loss. With data replication, information is copied via a secure Web connection to a remote data storage system. Consider a secondary data center to provide failover. Failover guarantees that information requests from the disabled primary data center are redirected to a secondary data center. Maintenance of a secondary data center will require additional hardware and software costs.

Another option is a hosted service, which for a monthly fee handles all aspects from storage to maintenance. Once the DR plan is developed and implemented, it must be tested. Beyond the technology, key personnel should have logistical plans if the organization's physical office is closed or impacted.

About the author
Girish Kumar is founder and vice president of sales and marketing of eClinicalWorks, an electronic medical records and practice management company in Massachusetts.