Risks of EHRs accessible only via internet: a cloud downside

The cloud, popular because businesses can pay a monthly fee for computer-related services instead of paying for costly in-house hardware and the staff to manage it, has its drawbacks. One of these became painfully evident for two days in mid-August. While the fact has received surprisingly little news coverage, the internet experienced intermittent periods of brownout worldwide on Tuesday and Wednesday, August 12 and 13. This was understandably alarming to healthcare providers who were unable to access patient records during these periods. Not all EHR cloud storage providers were affected, and those that were, were able to resolve the problem by the end of Wednesday. For cloud EHR storage vendors that invest in what are known as “system redundancies,” backup systems activated if primary systems become unavailable, business continued as usual during this period. Smaller healthcare practices in particular, tending to have smaller budgets to spend on their EHR systems, often choose more affordable EHR programs from vendors with less robust system redundancies in place. According to the Wall Street Journal, global internet traffic has grown too voluminous for the global routing system currently in place. While engineers are working to upgrade the routing system, progress on this project is not keeping up with demand and periodic brownouts are likely to continue to occur. Healthcare providers can protect themselves against the effects of future brownouts in various ways including investing in hybrid EHR storage systems, and including uptime guarantee clauses in their vendor contracts.

For more information see:
“Internet Outage Left Doctors Without Records For Hours – Huffington Post – internet – Google News,” News Journal Online (August 19, 2014)
“Internet Brownout Exposes Risk of Cloud-Based EHRs,” Medscape (August 22, 2014)
“The 512K ‘Crisis’ Makes Its Mark: Network Engineers Were Left Scrambling to Keep Web Customers Connected,” Wall Street Journal (August 18, 2014)

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