TY - JOUR
T1 - Understanding the scope of downtime threats
T2 - A scoping review of downtime-focused literature and news media
AU - Larsen, Ethan P.
AU - Rao, Arjun H.
AU - Sasangohar, Farzan
PY - 2020/12
Y1 - 2020/12
N2 - Electronic health record downtimes are any period where the computer systems are unavailable, either for planned or unexpected events. During an unexpected downtime, healthcare workers are rapidly forced to use rarely-practiced, paper-based methods for healthcare delivery. In some instances, patient safety is compromised or data exposed to parties seeking profit. This review provides a foundational perspective of the current state of downtime readiness as organizations prepare to handle downtime events. A search of technical news media related to healthcare informatics and a scoping review of the research literature were conducted. Findings ranged from theoretical exploration of downtime to empirical direct comparison of downtime versus normal operation. Overall, 166 US hospitals experienced a total of 701 days of downtime in 43 events between 2012 and 2018. Almost half (48.8%) of the published downtime events involved some form of cyber-attacks. Downtime contingency planning is still predominantly considered through a top-down organizational focus. We propose that a bottom-up approach, involving the front-line clinical staff responsible for executing the downtime procedure, will be beneficial. Significant new research support for the development of contingency plans will be needed.
AB - Electronic health record downtimes are any period where the computer systems are unavailable, either for planned or unexpected events. During an unexpected downtime, healthcare workers are rapidly forced to use rarely-practiced, paper-based methods for healthcare delivery. In some instances, patient safety is compromised or data exposed to parties seeking profit. This review provides a foundational perspective of the current state of downtime readiness as organizations prepare to handle downtime events. A search of technical news media related to healthcare informatics and a scoping review of the research literature were conducted. Findings ranged from theoretical exploration of downtime to empirical direct comparison of downtime versus normal operation. Overall, 166 US hospitals experienced a total of 701 days of downtime in 43 events between 2012 and 2018. Almost half (48.8%) of the published downtime events involved some form of cyber-attacks. Downtime contingency planning is still predominantly considered through a top-down organizational focus. We propose that a bottom-up approach, involving the front-line clinical staff responsible for executing the downtime procedure, will be beneficial. Significant new research support for the development of contingency plans will be needed.
KW - downtime
KW - electronic health records
KW - healthcare informatics
KW - hospitals
KW - patient safety
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U2 - 10.1177/1460458220918539
DO - 10.1177/1460458220918539
M3 - Article
AN - SCOPUS:85084536900
VL - 26
SP - 2660
EP - 2672
JO - Health Informatics Journal
JF - Health Informatics Journal
SN - 1460-4582
IS - 4
ER -