A piece of equipment that failed to protect Eastern Maine Healthcare Systems’ computers from a power surge was the likely culprit behind an outage Monday that affected internal systems at its hospitals and other facilities throughout the state, according to EMHS officials.
The temporary blackout prevented updates to patients’ electronic medical records and interrupted access to email, billing programs and a host of computerized systems at EMHS. The outage affected all of its eight hospitals, seven physician groups and other members from Portland to Presque Isle.
Health organizations have long relied on networked systems to coordinate billing and bookkeeping across multiple locations. But increasingly, those systems play a vital role in caring for patients, from electronic medical records to prescription ordering. An outage presents a patient safety issue, potentially affecting how doctors and nurses make decisions and carry out procedures.
“The challenge is we use it for direct patient care now,” said Ralph Johnson, past president of the New England chapter of the Healthcare Information and Management Systems Society. “It’s part of the tools, just like a stethoscope or drawing blood for a lab test.”
While EMHS clinicians couldn’t update electronic medical records during the outage, they could still view patients’ histories, according to Chief Information Officer Kyle Johnson. Visits and procedures were documented on paper, and those records were back loaded onto the electronic patient charts on Monday evening as the system came fully back online, she said.
Some medical procedures were delayed as a result of the outage, while lab work was processed in a timely fashion, according to EMHS officials. The system’s phone service was unaffected by the outage.
While EMHS is still investigating the outage, a preliminary review pointed to a failure of equipment in its Bangor data center that’s designed to throttle power fluctuations, Johnson said. Rather than managing that current, the equipment allowed a power surge to enter and damage EMHS’ data storage grid, she said.
“We kind of know what has happened, we don’t exactly know why yet,” she said.
She expected a final determination by early next week.
Working with Dell, its vendor, EMHS restored all of the data by drawing on a backup system that stores copies of the information, Johnson said. EMHS officials are researching how to bring that secondary system online faster to avoid such an interruption in the event of a future outage, she said.
“You try to prevent it first, but then if you do have the outage, how are we able to recover most quickly is the name of the game,” she said.
EMHS also operates data centers at its headquarters in Brewer and at another location in Brunswick.
No patient records or financial information were compromised as a result of the outage, Johnson said. All systems were brought back online in time to meet payroll deadlines and maintain the day’s billing cycle.
EMHS followed plans already in place for such an interruption, she said.
That included the use of “downtime kits” prepared for just such an occasion, said Kathy Knight, director of EMHS’ Center for Emergency Preparedness. The kits include prescription pads and other tools clinicians need to transfer documentation of patient care from the electronic system to old-fashioned paper forms. Staff practice using the kits once per month, and new employees are trained on them, she said.
“Technology is changing all the time, so we’re always making sure that we’re able to work in both arenas, with the electronic system up and running and with it down,” Knight said.
Hospitals rely on computerized systems to order prescriptions, which not only notify the pharmacy of needed drugs but also alert clinicians to dangerous medication interactions or other potential hazards, such as requests for an unusually high dosage. Doctors can still fax most prescriptions to pharmacies or write them out, but they must rely on tried-and-true stopgaps in the event of a system outage, such as checking a hard-copy medication formulary for potential interactions, according to Ralph Johnson, who also serves as chief information officer for Franklin Community Health Network.
His health system dealt with a weeklong outage of some of its computers in 2009 after a fire at its physician practices.
“It’s something we all dread happening,” he said.
