Contingency planning for electronic health record-based care continuity: A survey of recommended practices |
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| Affiliation: | 1. University of Texas School of Biomedical Informatics and the University of Texas – Memorial Hermann Center for Healthcare Quality & Safety, Houston, TX, USA;2. Department of Clinical Effectiveness and Performance Measurement, St. Luke''s Episcopal Health System, Houston, TX, USA;3. Houston VA HSR&D Center of Innovation at the Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA;1. Department of Radiology, NYU Langone Medical Center, New York, New York;2. Hackensack Radiology Group, PA, River Edge, New Jersey;3. Department of Radiology, Grandview Medical Center, Birmingham, Alabama;4. Harvey L. Neiman Health Policy Institute, Reston, Virginia;5. Department of Health Administration and Policy, George Mason University, Fairfax, Virginia;6. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;1. Division of Emergency Medicine, Cincinnati Children''s, United States;2. Division of Biomedical Informatics, Cincinnati Children''s, United States;3. Department of Pediatrics, University of Arkansas for Medical Sciences, United States;4. Department of Emergency Medicine, Vanderbilt University, United States;5. Center for Asthma Research and Environmental Health, Vanderbilt University, United States;6. Department of Biomedical Informatics, Vanderbilt University, United States;7. Department of Biostatistics, Vanderbilt University, United States;1. Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States;2. Geriatric Pharmaceutical Outcomes and Geroinformatics Research & Training Program, University of Pittsburgh, Pittsburgh, PA, United States;3. Division of Geriatric Medicine, University of Pittsburgh School of Medicine, United States;4. Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA, United States;5. Medical Radiation Sciences, The University of Sydney, Sydney, NSW, Australia;1. The H. John Heinz III College, Carnegie Mellon University, Pittsburgh, PA, USA;2. Aflac Center for Cancer and Blood Disorders, Children''s Healthcare of Atlanta, Atlanta, GA, USA;3. Department of Statistics, Carnegie Mellon University, Pittsburgh, PA, USA;1. National Institute for Health Innovation (NIHI), The University of Auckland, Auckland, New Zealand;2. Ocean Informatics Pty. Ltd., Brisbane, Australia;3. Department of Computer Science, The University of Auckland, Auckland, New Zealand |
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| Abstract: | BackgroundReliable health information technology (HIT) in general, and electronic health record systems (EHRs) in particular are essential to a high-performing healthcare system. When the availability of EHRs are disrupted, alternative methods must be used to maintain the continuity of healthcare.MethodsWe developed a survey to assess institutional practices to handle situations when EHRs were unavailable for use (downtime preparedness). We used literature reviews and expert opinion to develop items that assessed the implementation of potentially useful practices. We administered the survey to U.S.-based healthcare institutions that were members of a professional organization that focused on collaboration and sharing of HIT-related best practices among its members. All members were large integrated health systems.ResultsWe received responses from 50 of the 59 (84%) member institutions. Nearly all (96%) institutions reported at least one unplanned downtime (of any length) in the last 3 years and 70% had at least one unplanned downtime greater than 8 h in the last 3 years. Three institutions reported that one or more patients were injured as a result of either a planned or unplanned downtime. The majority of institutions (70–85%) had implemented a portion of the useful practices we identified, but very few practices were followed by all organizations.ConclusionsUnexpected downtimes related to EHRs appear to be fairly common among institutions in our survey. Most institutions had only partially implemented comprehensive contingency plans to maintain safe and effective healthcare during unexpected EHRs downtimes. |
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| Keywords: | Electronic health records |
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