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Adding Insult To Injury, Sutter’s Epic EMR Crashes For A Day

Posted on August 30, 2013 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

The Epic EMR at Northern California’s Sutter Health crashed earlier this week, leaving the system inaccessible for an entire day, reports Healthcare IT News. The system, which cost Sutter nearly $1 billion, went offline at approximately 8AM, locking out doctors, nurses and staff from accessing vital information such as medical lists and patient histories.

The crash followed a few days after planned downtime of eight hours which was scheduled to take place due to implement an upgrade.  During that period nurses could still read med orders and patient histories but had to record new data on paper and re-enter it later into the system, Healthcare IT News notes.

During the unplanned outage this week, the Epic system was offline at several Sutter locations, including Alta Bates Summit Medical Center, Eden Medical Center, Mills-Peninsula Hospital, Sutter Delta, Sutter Tracy, Sutter Modesto along with several affiliated clinics, the magazine said.

The outage drew the ire of the California Nurses Association, which called this incident “especially worrisome.” But the CNA notes that the crash is hardly the first time there’s been a concern over the Epic rollout. Nurses at Sutter have been complaining for months about alleged safety problems with the Epic system, notes the Sacramento Business Journal.

According to the CNA, more than 100 nurses had previously filed complaints at Alta Bates Summit, arguing that the Epic system was hard to use, and that computer-related delays had adversely affected the ability of nurses to monitor patients properly.

Sutter nurses’ complaints included the following:

• A patient who had to be transferred to the intensive care unit due to delays in care caused by the computer.
• A nurse who was not able to obtain needed blood for an emergent medical emergency.
• Insulin orders set erroneously by the software.
• Missed orders for lab tests for newborn babies and an inability for RNs to spend time teaching new mothers how to properly breast feed babies before patient discharge.
• Lab tests not done in a timely manner.
• Frequent short staffing caused by time RNs have to spend with the computers.
• Orders incorrectly entered by physicians requiring the RNs to track down the physician before tests can be done or medication ordered.
• Discrepancies between the Epic computers and the computers that dispense medications causing errors with medication labels and delays in administering medications.
• Patient information, including vital signs, missing in the computer software.
• An inability to accurately chart specific patient needs or conditions because of pre-determined responses by the computer software.
• Multiple problems with RN fatigue because of time required by the computers and an inability to take rest breaks as a result.
• Inadequate RN training and orientation.

Sutter officials, for their part, are not having any of it. Hospital spokeswomen Carolyn Kemp called the allegations that Epic was causing problems “shameful,” and argued that the accusations are arising because the hospital system is involved in a labor dispute with the CNA.

Meanwhile, Sutter execs are turning up the heat on nurses whom they feel aren’t using the EMR properly. According to Healthcare IT News, leaders have been scolding nurses whom they believe have not been entering all billable services into the EMR, which resulted in a loss of $6,000 in a single week, according to a July memo obtained by HIN.

Sutter’s spokesperson, Bill Gleeson, offered this official response:

Sutter Health undertook a long-planned, routine upgrade of its electronic health record over the weekend. There’s a certain amount of scheduled downtime associated with these upgrades, and the process was successfully completed. On Monday morning, we experienced an issue with the software that manages user access to the EHR. This caused intermittent access challenges in some locations. Our team applied a software patch Monday night to resolve the issue and restore access. Our caregivers and office staff have established and comprehensive processes that they follow when the EHR is offline. They followed these procedures. Patient records were always secure and intact. Prior to Monday’s temporary access issue, our uptime percentage was an impressive 99.4 percent with these systems that operate 24/7. We appreciate the hard work of our caregivers and support staff to follow our routine back-up processes, and we regret any inconvenience this may have caused patients. California Nurse Union continues to oppose the use of information technology in health care but we and other health care provider organizations demonstrate daily that it can be used to improve patient care, convenience and access. While it’s unfortunate the union exploited and misrepresented this situation, it comes as no surprise given the fact that we are in a protracted labor dispute with CNA.

When The EMR Goes Down, Doctors Freak Out

Posted on August 22, 2013 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Earlier this month, health IT superstar John Halamka, MD, MS posted a story talking about how network downtime within a hospital has changed over the past 10 years or so. I thought I’d share some of it with you, because he makes some interesting points about end user perceptions and sensitivities.

First, he tells the tale of a 2002 network core failure of Beth Israel Deaconess Medical Center, where he serves chief information officer. For two days, he reports, the hospital’s users lost access to all applications, including e-mail, lab results, PACS images and order entry, along with all storage. Or as he puts it, “For two days, the hospital of 2002 became the hospital of 1972.”

He then contrasts that failure with a recent one  (July 25 of this year) in which a storage virtualization appliance at BIDMC failed.  Because the hospital was loathe to risk losing data, he and his team chose a slower path to uptime — reindexing the data — which allowed them to avoid data loss. The bottom line was an outage of a few hours.

This outage was a different ballgame entirely, Halamka says. For example:

* In 2002, staff and doctors weren’t incredibly upset, but this time physicians were angry and frantic, with some noting that they couldn’t take care of patients without EMR access.  Here in 2013, end users expect network access to be like electricity, always there short of an act of God. Worse, though downtime simply isn’t acceptable, but procedures for dealing with it aren’t up to that standard yet, he says.

* Doctors are under an incredible set of regulatory burdens, including but not limited to Meaningful U se, health reform, ICD-10 and the Physician Quality Reporting System. They fear they can’t keep up unless IT functions work perfectly, he observes.

* Technology failures of 2013 are tricky and harder to anticipate. As he notes, back in 2002 servers were physical and storage was physical, but today networks are multi-layered and virtualized. While these things may add capability, they also crank up the complexity of diagnosing system failures, Halamka notes.

Halamka says he learned a lesson from the recent failure:

Expectations are higher, tolerance is lower, and clinician stress is overwhelming. No data was lost, no patient harm occurred, and the entire event lasted a few hours, not a few days. However, it will take months of perfection to regain the trust of my stakeholders.

This story does have one ray of sunshine in it — it demonstrates that increasing numbers of doctors depend completely on their EMR, a state devoutly to be wished for by many health IT leaders. But the price of having doctors throw themselves into EMR use is having them riot when they can’t get to the system. Clearly, hospitals are going to have to find some new way of coping with downtime.

Weekend Twitter Roundup

Posted on July 31, 2011 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A quick look at some interesting EMR and healthcare IT related tweets I saw this weekend.

This was timely after my recent posts about backup and disaster recovery.

Interesting comparison for sure.

As a physician advocate, I always love physicians’ perspectives.!/lsaldanamd/status/97132994258665472