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Hospitals, Doctors And Patients Impacted By Unplanned EHR Downtime

Posted on June 18, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

EHRs are going to crash and go offline from time to time. But are physicians and hospitals prepared to deal with the fallout when this happens? The answer seems to be “maybe.”

Of course, physicians and hospitals have plenty of reasons to avoid EHR downtime.

For one thing, EHR crashes can have a major impact on care delivery. After all, without EHRs, physicians may have no access to patient data, which could lead to care complications or adverse events.

Also, downtime adds addition pain (and expense) to the situation. According to one estimate, unplanned system failures can cost $634 per physician per hour. Meanwhile, according to Dean Sitting of the University of Texas, a large hospital may lose as much as $1 million per hour when their EHR is down. Those are scary numbers.

Unfortunately, despite the costs, strain to the hospital operations and consumer complaints arising from downtime, many hospitals refuse to invest in preventive technologies such as a backup data center, arguing that they’re just too expensive. As a result, hospitals can be offline for a long time when their EHR system crashes, which typically has a nasty ripple effect.

One example of how EHR downtime affects hospital operations comes from Sutter Health, the largest health system in northern California, whose EHR went offline for more than 24 hours in May. The crash took place when a fire-suppression system was activated in the system’s data center.

During the shutdown, Sutter hospitals followed a series of steps often used by its peers, such as cutting elective surgeries, transporting patients to other hospitals and discharging patients who weren’t very sick. They also switched over to paper records. But despite these efforts, Sutter still faced some problems that weren’t addressed by its plans.

For one thing, younger doctors were thrown a curve ball, as many had never worked with paper charts. This alone gummed up the works during the downtime episode. There were no signs that these doctors made any mistakes due to using paper records, but the risk was there.

Then there were the effects on patients – and some were ugly. For example, when Santa Clara resident Susan Harkema’s father died, she called Sutter Health’s Hospital of the Valley to arrange for removal of his body to a crematorium. According to a story appearing in San Jose Mercury News, Harkema tried a hotline and backup numbers but couldn’t reach anyone due to the outage. It took 8 hours for a hospice nurse to arrive and collect the body, the newspaper reported.

Another patient tweeted that they had to go out of the Sutter system for critical care, which left the treating physicians without care history to review. “It was stressful and scary, and we still aren’t sure we have a successful outcome,” they said.

The net of all of this seems to be that hospital downtime policies could use more than a few tweaks, and more importantly, a better failsafe protecting EHRs from going offline in the first place. Sure, no EHR system is perfect, and crashes are inevitable, but providers can be better prepared.

And the #AHIMACon12 Winner Is …

Posted on October 3, 2012 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

… ICD-10 by a landslide. For those of you wondering whether “upcoding” might just steal 10’s thunder, it wasn’t meant to be. Providers and vendors alike brushed aside the phrase – some with a shrug of the shoulders, others with a roll of the eyes, and some with a “What did you expect?” The general consensus I gathered on the show floor was that technology such as electronic medical records enables doctors to code more accurately – not fraudulently. Everyone agreed that paper-based processes have for years resulted in doctors under-coding, and now that technology and workplace culture have caught up, those same doctors are finding it more efficient to code accurately, thus leading to more accurate, i.e. higher, reimbursement.

Speaking of reimbursement, John mentioned in a recent blog that ICD-10 is on the list when it comes to Top 5 Revenue Cycle Management Issues, and I couldn’t agree more. Talking with vendors and their physician customers at the show brought home to me just how fine a line providers walk when it comes to coding and revenue. As we move closer to Oct. 1, 2014, and the final push towards ICD-10, I am eager to see how these more granular, accurate codes play out in the revenue space. If a doctor codes more accurately in 10 (and hopefully provides quality care at the same time), and as a result sees higher reimbursements, will this somehow turn into a price increase that will trickle down to patients through payers? Where will the touted cost-effectiveness really come in? At any rate, I am definitely seeing the cause and effect relationship between coding and revenue more clearly as the ICD-10 deadline draws near.

ICD-10 was the focus of the only educational session I was able to attend, and it was well worth the time. “The Good, the Bad and the Reality: Lessons from the Frontlines of ICD-10 Implementation” featured the stories of Sutter Health, Vanderbilt University Medical Center and Deloitte Consulting. Both Danielle Reno from Sutter Health and Gary Perrizo from VUMC stressed strategy, education and testing in the run up to 2014. I got the impression from them and the physicians in the audience with me that though everyone is grateful for the extra time to make the switch, no one should be taking the time for granted. “Lollygagging” as I tell my children, is not advisable.

As you probably know by now, I’m a big fan of social media in the healthcare space, and I was very impressed with the efforts the AHIMA team took to incorporate social networking into just about everything – especially compared to last year. The attendees at AHIMA seem more like a Facebook crowd, and that was indeed the sentiment I heard from several vendors. That being said, I do think the tweet stream was more active than last year, probably due in large part to the @AHIMAResources team taking a proactive approach to socially marketing the event. I hear that next year (the event will be in my hometown of Atlanta) we’ll see the hashtag on all the slide presentations, which may encourage attendees to get in on the tweeting action.

Overall it was a fun, educational first trip to Chicago and second trip to AHIMA. (You can check out some of the more memorable images from the show below.) Seeing the sun rise and set over Lake Michigan in early Fall was a real treat. I hope that Atlanta will have equally spectacular vistas to offer next year.

AHIMA 2013 will take place in Atlanta Oct. 26-30.

This book caught my eye on the show floor. Anyone read it yet?

This picture does no justice to the spectacular views I had from the 95th floor of Chicago’s John Hancock building, thanks to the fun folks at Healthport.

The Precyse team flew a special member in just for the show.

The Friedman Marketing group was nice enough to hold another tweetup after show hours.

My coworkers presented me with a lovely birthday balloon bouquet from one of the two balloon artists on the show floor.