Policy Statement

This facility follows current guidelines and recommendations for the procedure when there is a downtime of the Electronic Health Record (EHR).  

  Definitions

There are 4 Different types of downtime and ways to prevent: 

1. Loss of internet

2. Loss of power

3. Unscheduled PCC maintenance outage, if outage last greater than 60 minutes notify EHR support for guidance. (see below)

4. Scheduled PCC maintenance outage that lasts less than 2 hours, usually during the night, facility is notified in advance and can plan their documentation around the interruption.

 

Preventive Measures

1. Quarterly check or more often as needed should be performed to desktops and/or laptops to ensure physical connectivity is maintained.

2. Facilities must maintain a locally maintained backup, read-only EHR system or second internet source that is differentiated from the live/production EHR system.

3. Facility maintain electric generator and sufficient fuel available to support the HER during an extended power outage.

4. Facilities should have internet source plugged into emergency outlet so that internet is not lost.

5. Laptops should be charged nightly to ensure documentation is not delayed due to lack of power.

6. Back up computer should be connected to emergency generator power outlet

7. Dedicated printer connected to emergency generator power outlet with adequate capacity to print all MAR/TARs, including ink and paper

 

 

 Policy Interpretation and Implementation

 

Scheduled Downtime occurs, staff will be informed via the Home page.

 

1. During the time listed staff will access the eMAR backup system and print MAR/TARs for the anticipated loss of software access.

2. Post Downtime, all documentation written on paper must be entered into the system and paper documents filed in the residents chart.

 

When an unscheduled Downtime occurs, please contact the following in this order:

1. Contact and inform Administrator, Director of Nursing, Supervisor, and Maintenance department of inability to access the Health Medical Record possibly restore power or Internet access if applicable.

2. Contact IT provider if necessary for system restore.

  a.  HOCS number is 718-377-0922 option 2/

  b.  email support@hocsinc.com

3. Contact the E.H.R. team-via email/Hotline-718-557-7322/office 718-215-6000 ext 612(Monday thru Friday from 9am-5pm)

Call 1-888-551-9296. All other times including weekends.

4. In the event that restoring services is not possible before disruption of service to residents occurs, all disciplines including remote users must be made aware of the interruption in service.

IT, Administration and or E.H.R. Dept will inform pharmacy and inform them of the downtime and to expect hand written, faxed orders.


 System Downtime Documentation

For downtime lasting more than 4 hours or sooner, based on the medication administration time, the backup eMAR must be accessed and paper Medication and Treatment Administration records printed and distributed to the staff for documentation. All other documentation will be done on paper until the system is restored.

 Facility will perform logged regular checks, to ensure that the eMAR Backup is downloading and able to be printed in the case of an emergency. 

 A hard copy of assessments forms, progress notes, flowsheets etc (blank) should be maintained at the facility in the event of an emergency. The organization maintains enough paper forms to care for residents on the unit for at least 8 hours. Paper forms could include those required to enter orders and document the administration of medications, labs, and radiology on each unit.

 Ensure there a system exists to admit new patients during downtime, including assignment of unique temporary patient record numbers These new resident IDs must be  reconciled once the EHR comes back online.

 Ensure that paper documents created during downtime are protected using standard HIPAA safeguards and policies.

 

 If downtime is related to a loss of facility power all necessary equipment will be plugged into the emergency outlets.

 If the downtime is related to internet outage, all documentation will be on paper as detailed above.

Twenty four hour reporting.

 In the event the electronic medical record is not functioning to provide electronic 24 hour report. A paper 24 hour report will be initiated until system is brought back up. 

 

Recovery post Downtime

1.  Ensure that all information recorded on paper during the downtime gets filed in the resident’s chart and entered into the EHR following its reactivation (e.g., this could be entering information as coded data or scanning of paper documents).

 

2. Staff are trained and tested on downtime and recovery procedures.