The recent communications outage at Sutter Health, the largest health system in northern California, which cut off access to electronic health records (EHRs), highlighted the frequency of such outages and the need for backup plans and drills nationwide.

The recent communications outage at Sutter Health, the largest health system in northern California, which cut off access to electronic health records (EHRs), highlighted the frequency of such outages and the need for backup plans and drills nationwide.

During the shutdown, some elective surgeries were rescheduled, some procedures were delayed, and some patients were discharged. The 24-hospital health system executed its downtime plan and reverted to paper-based charts.

In a video message, Sarah Krevans, Sutter Health president and chief executive officer, told employees and physicians, "I am disappointed that this event meant we were not able to meet all the needs of all those we are privileged to care for."

She said that a multidisciplinary team, including outside independent advisers, would investigate the outage, which began when a fire-suppression system was activated at one of Sutter's data centers. There was no property damage to the data center.

Sutter spokesperson Dean Fryer told the San Francisco Chronicle that the cause for activation of the system was not a fire or data breach but did not disclose details.

All Systems Have Risk

Andrew Gettinger, MD, a chief clinical officer for the Office of the National Coordinator for Health Information Technology, part of the US Department of Health and Human Services, said all systems need backup plans and pointed to the recommendation from the Joint Commission for annual disaster drills.

"It's not a question of IS your system going to be unavailable, because I think almost every computer system in every context is at some time or another not available," he told. "The question is then what's the institutional contingency plan?"

Gettinger said that downtime for computer systems is not unlike other disasters health systems plan for regularly. "It's no different from what happens when the power in the building goes out or the water supply goes out, or you're no longer able to get compressed oxygen or nitrous oxide," he said.

SAFER Guidelines

All health systems should know about the SAFER guides (Safety Assurance Factors for EHR Resilience), put in place to address EHR safety nationally, Gettinger said. The guides were updated last year.

Dean Sittig, Ph.D., a professor at the University of Texas Health's School of Biomedical Informatics, helped write those guidelines and also was the lead author on a study in 2014 that surveyed US-based healthcare institutions that were part of a professional collaborative on their exposure to downtime.