Home Forums Discussions General Discussion Worst Case Scenario

knock on wood, hopefully this does not happen.

I hate paper, that's why I believe in using EMR. But being around computers for all these years, I know that one day it will feel like the end of the world, meaning, the computer is dead for whatever reason. I still remember the day when I dictated 20 visits and at the end of the day found out that the battery of my dictaphone was dying and my voice was like Mickey's voice.

so, what do you all do? What is plan B?

I read about lost charts form previous posts. When does it happen? I am thinking of holding on to one piece of paper with vitals, assessment and plan for that scenario.

Thanks, Ben

In our office, we built contingency plans into our setup. We set up a plan for simple equipment failure and also disasters such as office fire or theft. You can spend a lot of money so you need to assess your risk vs. ability to pay and need to restore quickly.

Simple equipment failure was addressed through redundancy. Having a spare client so that you can simply move from one computer to another is a big part of this plan. Second part is setting up your server so Hard drive and key components can fail without affecting your office. Hard drives fail the most so start there. We adopted RAID 5 setup for our drives. There are many posts on how to configure this and what RAID level. When buying a server, think redundant power supply & network card.

Power outage risk should also be minimized with purchase of Uninterruptible power supply (UPS) like those we bought from Cyberpower Cyberpower 900W UPS
UPS should be on your server and your network gear so they can be properly shut down in an outage.

For major disaster or theft, a strict Backup schedule with regular confirmation of backup confirmation is needed. Some people use Mozypro, AC's backup service or their own manual USB drive schedule. We use Mozypro. All ways work but that one that works best for you will be the one you do consistently.

If all power was off in an office, you should also have printed, blank encounter pages ready to be used. These handwritten notes would then be entered into AC after power was back on. Think Katrina.

I suppose you could print out notes after you do them but I believe that is overkill if you have taken basic precautions securing and backing up your data and implementing redundancy.

Few people have ever lost notes. Although rare, if it happens and it can't be fixed, I would recommend that an office print all notes until the situation is addressed. I certainly wouldn't start doing this though until a note was lost.

We were an office that had some charts lost and I printed paper copies for several months but now we just check off all charts at the end of the day to make sure they are there before logging out. With the last upgrade 4.073 we have not had missing charts.

Ben,

These lost notes are an abberation. Not to make light of those who are having that issue. And, it probably has something to do with their setup.

I have been doing this a long time. I must say we went live in two days. But, I will admit to the AC crowd that we printed out notes for one month until we felt comfortable.

As Eric says, the two things people for get are backups and power backups. He is right on when he talks about Cyberpower. The Cyberpowers are heads above APCs. The 900Ws are perfect for your clients and the 1500s for your server. Just remember, on the back there may be six outlets. Three will be for power outage and the other three only for voltage protection. If you can, please get the extra protection of AVR. The UPS portion makes sure that you have power is the event of a power outage and as Eric says can shut you down in the right way. Hopefully, you will either be around to do that or, if you are gone, you would have logged out anyway making that a non-issue.

Back to AVR. AVR = Auto voltage regulator and what it does is keep the voltage at a constant 90 to 115 or so. Power companies are notorious at having brownouts which means at times your voltage will go from 115 to 75 in a second which is horrible for flatscreens. Also when power goes out, you frequently will have that issue.

The Cyberpowers also fit in rack systems beautifully. One other piece of info on battery backups. No matter how well you set it up, i.e. shutdown with 20 minutes left, etc. they are notorious for coming in on Monday with no power. If you can afford it, if you can purchase two extra 900 Watters that just charge all the time, you can power up your server and front desk and get anything you need for that day if need be.

Just some thoughts. But, don't feel bad printing out notes for a few weeks. You would be crazy not to. And, it keeps peace and harmony in the office as some doctors aren't quite ready to make that switch.

IRONY AHEAD: I read an article once that was funny and eye opening. All of these EMR companies preach that you should be paperless and all the money you save. So go to their headquarters (if you live nearby and ask for a tour). And, then look around and see how much paper they are using. I bet it's tons.

Or just walk up to their table at a medical meeting. Tons of paper, and you get a free pen.