Disasters such as earthquakes, typhoons, floods, and large-scale blackouts can shake a hospital's care foundation in an instant. If the EHR becomes unusable, access to patient basics, prescriptions, and test results is lost, making safe continuity of care difficult. That is why incorporating EHR disaster measures into a business continuity plan (BCP) is essential.
This article organizes disasters' impact on care, then concretely explains the preparations to secure in practice, from multi-site backups and power supply to paper operations during outages and reflection after recovery.
How disasters affect care
In a disaster, three things become problems first: power, network, and terminals. Blackouts stop servers and terminals; if communication is cut, cloud and external links become unusable; and building damage can lose the terminals themselves.
When these overlap, you can neither record nor reference care. Rather than leaving impact at troublesome if it happens, concretely anticipating which functions, stopped for how long, affect care how is the starting point of effective preparation.
Why EHR disaster measures matter
In the era of paper charts, if the building was safe, care records remained at hand. But now that the EHR is central, if the system stops, neither past nor new records can be handled at all. In exchange for convenience, we must be aware of carrying the risk of dependence on the system.
It is precisely in disasters that information such as patients' underlying conditions, allergies, and medication status governs safe care. Being unable to access these directly leads to risks such as medication errors. That is why how to protect EHR data and how quickly to restore it to a usable state is at the core of a hospital BCP.
Incorporating the EHR into the BCP
A BCP defines what to prioritize for continuity and recovery in a disaster. For the EHR, decide at minimum which information must be viewable by when to continue care, and design preparations working backward from that.
- Prioritize the care functions to keep running
- Set an acceptable downtime (RTO) and recovery target
- Define the minimum set of needed information (prescriptions, allergies, etc.)
Identifying risks assuming a disaster
Before designing preparations, it is important to concretely identify what disasters affect your hospital and how. Conditions differ by facility: regional earthquake and flood risks, building seismic resistance, the location of the server room, and whether backup power exists during outages. Only by grasping your hospital's specific weaknesses can you devise effective measures.
For example, weaknesses such as a server room on a flood-prone lower floor or short emergency-power runtime only become targets for measures once identified. Prioritize by the magnitude and likelihood of anticipated damage, and allocate limited budget effectively.
Protecting data with multi-site backups
The core of disaster measures is not concentrating data in one place. Keeping data and backups only within the hospital risks losing both the primary and the backup at once from building damage. Distributing backups across multiple sites, including remote locations, is important.
Also, regularly verify that restoration from backups actually works. Even if taken, backups are useless if restoration procedures are unclear or take too long. Document recovery procedures so they can be executed even when the person in charge changes.
Securing power and documenting recovery procedures
The EHR does not run when power stops. You must decide in advance the capacity and runtime of emergency power, fuel supply, and which devices to prioritize for power. Preparing for brief outages with an uninterruptible power supply (UPS) is also effective.
- Confirm emergency power capacity, runtime, and refueling
- Decide the priority order of devices for power
- Document startup and recovery procedures so anyone can execute them
Paper operations during outages and reflection after recovery
When systems stop completely, paper operations are the last line of defense. Preparing alternative forms for prescriptions, orders, and records in advance and deciding what information to handle on paper lets care continue amid chaos. Regular drills to familiarize staff are also important.
After recovery, information handled on paper must be accurately reflected into the EHR. Without procedures for when, by whom, and in what order to enter it, records get missing or duplicated. Write these post-recovery operations into the BCP as well.
Peacetime drills and structure
No matter how well plans are prepared, they are meaningless if you cannot act when it matters. Regularly conduct tabletop drills assuming blackouts and communication loss, and drills for switching to paper operations, surfacing gaps in procedures and ambiguity in roles during peacetime.
It is important to reflect issues found in drills into the BCP and keep growing the plan. Avoid a state known only to one person, and ensure multiple staff can execute procedures so you can respond even in a disaster when the owner is absent. Multi-profession drills also offer a chance to confirm inter-department coordination.
- Conduct tabletop drills assuming blackouts and communication loss
- Drill switching to paper operations in practice
- Reflect drill insights into the BCP
Raising resilience through the cloud
A configuration that maintains systems only within one's own building becomes fragile the moment that building is hit. Placing data in a remote cloud and making it redundant across multiple sites protects information even if the building is damaged and eases early recovery from another site.
Our Sakigake Platform is designed on the premise of such multi-site redundancy and backups to protect EHR data even in disasters and raise resilience. It can be an option to raise the level of preparation to match your hospital's operations.
Summary
Disasters threaten power, network, and terminals at once, and an EHR outage makes continuity of care difficult. That is why it is important to decide which functions to keep running, distribute backups across multiple sites including remote ones, document power supply and recovery procedures, and design paper operations and post-recovery reflection. Keep honing preparations through drills while raising resilience with the cloud.
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