Home Forums Discussions General Discussion The Last Word On Backups

Well, this probably won't be the last word, and I would expect there will even be some words even on this thread. And, what I am about to say pertains more to me than anyone.

I have ready many, many posts in many, many threads, and I am beginning to see one common theme. There are as many ways to do backups as there are IT people and people using computers. I think we have talked about this issue exhaustively, I don't think all of us continuing to list how we do it is being very helpful. Rather, I think it would be more helpful if a few guidelines were listed, and people could decide how to do it themselves. If they then have questions, they can post on the boards, read the past posts or email/PM someone whose philosophy seems closest to theirs.

A couple of general statements: There are two types of people out there. Those who have lost data, written over data, deleted data, had hard drive crashes or have found themselves with corrupt data. The other type are those who don't use computers. Sooner or later you will have an issue with your data. This can be anything from trying to recover one day's worth of notes or losing your entire hard drive. A good many people do not back up their data or do not have a good backup plan. Here are some guidelines I am listing.

1. Backups should be done every day preferably at night. Depending on your needs, this should be a backup of the entire system or just certain folders such as AC.
2. Backups should be checked weekly to insure they are being backed up correctly, and they should be tested.
3. Backups should never be backed up to the same computer you are backing up unless it is a completely SEPARATE hard drive. Even then, it is not a good idea for that to be your only backup.
4. Backups should be backed up to multiple media, whether it is thumbdrives, CDs, tapes or external hard drives. No one wants to have their hard drive crash and then find out their only backup is corrupt or missing.
5. The number of external hard drives and/or how deep (the number of backups on a hard drive -- i.e. a month's worth of backups vs one day) should be directly proportional to how critical your data is. Next to Citibank's data or the Pentagon's, I cannot think of too many things more mission critical than your patient data, patient schedule and billing. To back this up only to a thumb drive is a little shaky.
6. While not a hard and fast rule, one should have both automated and manual backups. It is easy to get lazy with manual, and the automated are helpful. It is easy for the automated to not be checked and work improperly, so the manuals are helpful. Personally, I like to back up everything every night while doing small manual backups of AC, Medware (billing and scheduling) and one other program I run. But, now I am getting back to giving out my way of doing things.
7. Backups should be done at the office so they are accessible and more likely to be done, and should be taken home on regular basis (nightly or weekly).
8. One should really sit down and come up with a strategy which works for them. One should understand that backups are not just for the computer which crashes today and the use of the backup from tomorrow. One should also think of the deleted file from two months ago, which is only contained on a backup from two months ago.

This is off the cuff. I may add some later. Just some ideas since I really feel as though we all getting off into tangents of how WE do backups and not the strategy each person should employ. I think it is important for each person to understand why backups are needed and the reason they are done certain ways. I am sure you can Google these ideas. I would recommend Googling "Backups and Grandfather strategy." My guess is you will get thousands of hits and reading about the above will go a long way in understanding.

Excellent words, Bert.

I have taken your advice and found some articles on backup strategies. I am going to meditate on them, and let their wisdom seep into my consciousness.

You hinted that you might have a few more thoughts to add for completeness. When you feel you have rounded out your post, I would like us to take the salient points and create an Amazing Charts Wiki article out of it.

People ask about this topic very often and it would be good to have a fixed address to direct people to, instead of re-typing everything or doing a search and posting links to the old posts.

No Bert, I'm taking the last word...

Brian,

I agree. And, I think that after reading and sifting through all of the backup posts, having a generalized EBM outline makes more sense.

Bert, I'm taking the last word again.

There are many online backup solutions like Mozy backup(www.mozy.com) and Amazon S3 service. I am not sure if S3 is HIPAA compliant or not, but Mozy is.

I would do everything, manual backup, automatic backup to second internal HD, backup to another share on the network and then the online backup to use something like Mozy. It does not hurt to have multiple copies.

Wow, Thank you Nephron.

Mozy is goood.

It is free for 2 GB !
It is very easy to use, user friendly web based which we are familiar to.
And it AUTOMATICALLY back up once I set the folder to back up. I like this AUTOMATIC back up feature !!

Unlimited back up (no limit of size) is only $5/month !!

Thank you for information !!

Alan Chang Kim, MD

My practical intranet knowledge is woefully short. (AC is replacing a DOS system!) We employ multiple backups in small part from ignorance and terror, but I did find one interesting point. We expanded on our personal disaster plan, (at a meeting, question, "OK, the building burns to the ground during the night, now what?") Answering that question helped us to visualize what the backup must be capable of AND the spin-off benefit from a marketing standpoint: Prospective patients who are leery about EMR's ask "Oh yeah? Well what do you do if there is a power failure?" Now my answer nails them to the floor, "Of course I stop seeing patients while we get it fixed, because the elevator stops, the lights go out and Air Conditioning shuts off. But I'll tell you this: For the first time in 20 years I have a plan if the Building Burns down, which by the way would destroy all of the paper charts forever! If we have a fire, I am stopping at Mickey Thompson RV rental on the way into work and getting a big RV. Our office manager is calling Todd at Computer Technology Unlimited, and getting him to bring a server, router and hub, with a few laptops over to the RV. We will backup from AC on the East Coast, and be able to start handling calls from the parking lot in about 6 hours." Very effective argument. (And the backup must be in more than one site, too cheap to do and to risky not to do!)

Great fire plan, Doc!

MacGyver would be proud.

Wow! I am impressed. I think I will work on a similar plan. I have several patients that sell RVs....I think I'll give them a call. Thanks for the great ideas!

Leslie

Caveat: It is our plan. We have never done it. We have never walked through it. But even talking about it has made us realize we forgot the phone service. I THINK our exchange can forward the calls for us. I really don't know and NONE of the phone numbers exist outside the office. But now we are working on the details of all this, and printing all the numbers, (accounts and access info etc.) on a few sheets of paper to be stored in a few (remote) safe places and on the flash drive in my pocket.