The coupling of modern technology with medical research has greatly increased longevity and improved the quality of life for countless patients. Technology utilized in day-to-day operations has revolutionized the receiving, storing and accessing of healthcare information. With automation throughout the healthcare industry becoming standard, along with compliance requirements necessitating sophisticated backup and recovery systems, healthcare organizations are challenged to deliver quality healthcare while maintaining up-to–date technology.

Yet, as healthcare moves in a direction where Health Information Technology (HIT) and electronic health records (EHR) are ubiquitous, questions regarding the reliability of automated IT systems arise. In a nutshell, critical healthcare systems can’t afford to go down. In fact, IT analyst group Gartner suggests that every healthcare organization’s systems need to have some level of formal high availability (HA) solution to provide at least 99.99 percent uptime. In addition, the College of Healthcare Information Management Executives (CHIME) emphasizes that HA should be a primary concern when rolling out clinical automation systems.

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HA environments are not complicated. They consist of two or more similar computers (or servers) where one functions as the primary production processor, while the backup is kept up-to-date in near real-time. System software handles the replication and monitoring process on both servers. When the primary server fails or must be taken offline for maintenance, users can readily be switched over to the backup server. Any connections with other networked systems can also be reestablished on the backup server. When the primary server resumes production processing, users and other networked systems can be returned to the original primary production server through a process referred to as “failback”. In regards to healthcare, this architecture allows practitioners to use automated systems with confidence.

Not all healthcare systems are truly critical, however. For the most part, only those that directly impact patient care, such as the hospital’s code paging system, fall into this category. Additionally, critical systems are often organization-specific. But as a starting point, here are seven healthcare systems worth considering for any critical ‘cannot go down’ list:

1. Patient Record Systems
Patient populations continue to increase in acuity as each patient requires more active monitoring and more intense nursing and physician management. To conserve scarce resources, healthcare organizations rely on EHR systems to assist with direct patient care activities, such as automated or semi-automated monitoring of vital signs. As EHR systems play more extensive roles, when they go down, resuming manual delivery of these services can be extremely difficult, frustrating and time-consuming.

2. Nursing Resources
With the long-term shortage of skilled nursing personnel, many healthcare organizations are utilizing fewer nurses for more patients. To function efficiently in this situation, available nurses must be equipped with appropriate clinical automation capabilities, such as vitals documentation via PDAs or smartphones, critical to sustain the personal attention and so essential to the nurse-patient relationship. Downtime in this department reduces quality patient care and can have serious consequences.

3. Care Management Protocols
As healthcare shifts toward evidence-based treatment, the use of care management protocols increases. Automated systems that support workflow, clinical decision support, controlled medical vocabularies and physician order entry, help carry-out and monitor these protocols which oversee and implement many care management processes used to treat complex diseases. System downtime in this automated environment can have a devastating effect on the delivery of clinical care, resulting in medical errors.

4. Point-of-Care Instrumentation
Point of care technology, such as bedside monitoring and treatment devices have become increasingly more intelligent. Linked to EHR systems that monitor with software-powered alert functions, these devices have become more vulnerable to interruptions in system operations. As more control and calibration work is handled by software and these devices become more GUI-based and user friendly, any interruption in the EHR system will make it less likely staff will have the expertise to manually control the device without risk of human error.

5. Automated Medication Administration
Many healthcare organizations are utilizing bar-coding to help eliminate errors in medication administration while additionally documenting and verifying medication administration processes. Downtime within this EHR system places an additional time-consuming burden on already over-worked nursing staff that must resort to error-prone manual backup procedures.

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6. Case Documentation
Automated systems are replacing manual case documentation allowing clinicians to receive immediate feedback with less errors and increased efficiency. However, once an automated system has been adopted, any interruption in system availability creates a delay, potential bottleneck or error situation, since the clinician cannot document an event or issue.

7. Physician Order Entry
Advanced software systems are streamlining the physician order entry process—from creation of order sets based on individual patient’s diseases to safety checking orders at entry time. Yet, physicians accustomed to the automated system and who rely on the ease and efficiency, safeguards and conveniences, become dissatisfied when the system goes down, increasing the risk of errors.

IT Safety Net
The adoption of automated healthcare systems are providing physicians and staff faster, more accurate and consistent information, with more ease than ever before. Reliable storage and access is essential in healthcare, but when it comes to patient care, not all data is critical. In an industry devoted to saving lives, identifying critical data systems and developing a safety net in case of failure is just good medicine.

Bob Gast is an IT industry analyst and writer for Vision Solutions. He has been firmly anchored in the IT industry for nearly three decades and is also a technologist, author and speaker.