The 24-hospital Sutter Health system in Northern California was the talk of the town late August after a software glitch rendered its $1 billion Epic electronic health record system inaccessible to nurses and clinical staff throughout all Sutter locations. 

On Aug. 26 at approximately 8 a.m., the Epic EHR system failed, at which time nurses, physicians and hospital staff had no access to patient information, including what medications patients were taking or required to take and all vital patient history data, according to reports from the California Nurses Association, part of National Nurses United, the largest nurses union in the U.S. 

"Many of the families became concerned because they noticed the patients were not getting their medications throughout the day,” explained Mike Hill, RN at Sutter’s Alta Bates Summit Medical Center and CNA representative for the hospital. "Meds were not given for the entire day for many of the patients."

Officials at Sutter Health confirmed the outages. On the morning of Aug. 26, "we experienced an issue with the software that manages user access to the EHR," wrote Sutter Health spokesperson Bill Gleeson, in an emailed statement to Healthcare IT News. "This caused intermittent access challenges in some locations."

By some reports, the issue was caused by a Citrix glitch, but Sutter officials wouldn’t confirm the vendor. The Sutter Health IT team applied a software patch later that night to resolve the issue and restore access. "We regret any inconvenience this may have caused patients," said Gleeson, who added that throughout the glitch, the "EHR was live," despite users being unable to access it.

Hill said it caused more than inconvenience, as "everything went down including the backup." Even when nurses attempted to use the health system’s Pyxis medication management system to print out patient information, the data was outdated by two to three days. "The nurses basically were operating blind that day," Hill added. 

Other readers argue that Sutter responded swiftly and efficiently. Reader Anish Arora, founder and president of healthcare IT consulting firm Afyatech and has worked with Sutter before, said, "No time was lost, no stone left unturned to fix the problem as quickly as possible."

Some Healthcare IT News readers were shocked over this amount of downtime. "The IT department should not even be taking down the EHR for eight hours for a planned upgrade anyway. They need to find a better way to manage upgrades," said Martalli, in a comment posted on the Healthcare IT News web site.

Days earlier, the EHR system was also reportedly down for eight hours due to a planned upgrade; nurses could still read medication orders and patient histories but had to record new data on paper to then be re-entered into the system later. 

"All information such as medication administration records and patient histories was outdated by two to three days," added Hill. "There were no orders that could be seen of any kind through the day so nurses called for what they needed."

Gleeson explained that CNA continues to oppose the use of health information technology and ultimately misrepresented the situation. "It comes as no surprise given the fact that we are in a protracted labor dispute with CNA," he said.

Hill was quick to clarify: "CNA has never been opposed to technology because technology is part of what is going on." What some 5,000 Sutter nurses represented by CNA do have an issue with is the lack of inclusion in the (EHR) design process.”

Recently, nurses at Sutter Health have come under fire for failing to enter all the billing charges into the EHR system, which has resulted in the hospital reporting a loss of more than $6,000 in charges in a single week, according to a July memo sent to staff. "We can’t afford to operate like this," wrote Joan Fosenburg, women's health department manager, in the memo. "If you do something that is chargeable, charge for it!!!"

"We have been on Epic for 5 months now, and we can no longer have incorrect orders, missing information or incorrect or missing charges. Starting on September 1st, errors made in any of the above will result in progressive discipline," according to another hospital memo sent to staff.