Downtime is perhaps the most loaded word in the IT lexicon. What other single word can induce fear or spark finger-pointing and awkward discussions? Was IT unprepared? Was a vendor at fault? Were budget shortfalls the root cause? Who is responsible?
Downtime is undesirable in any industry, but it poses an additional element of risk in healthcare environments. Healthcare is dependent upon electronic data and computer systems. Whether it’s planned or unplanned, downtime may jeopardize patient care. It can also impact revenue if you have to postpone when profitable elective procedures.
Unfortunately, downtime is sometimes necessary when implementing maintenance updates and security patches. To explore how healthcare organizations can reduce their risk and maintain operations during planned downtime, I talked with two Pure Storage® experts: Priscilla Sandberg and Chris Bokis.
Priscilla and Chris know a thing or two about electronic health records (EHRs) and data protection. Priscilla is Pure’s senior healthcare strategic alliances manager. Prior to Pure, she spent 16 years as a senior sales representative at MEDITECH. Chris is also a MEDITECH alum, having worked at the company for 24 years, most recently as the director of infrastructure. He joined Pure in 2019 as principal engineer for MEDITECH solutions.
How do you bring up the subject of downtime with hospital IT executives?
Chris: Planned downtime in a hospital is scary. IT directors cringe when we talk about the evil “D” word—downtime. We see them sit back, sigh, and possibly think “how can a storage vendor help me prevent downtime?”
When we start talking about flooding, tornados, earthquakes, and power loss, the customers cross their fingers and say, “We hope that stuff never happens, but we do have downtime procedures for those.” When those scenarios happen, everyone in the organization knows why. They get it. They know IT is at the mercy of the elements and they understand.
How does the conversation change when you mention planned downtime?
Priscilla: When those same people ask for downtime to do maintenance updates or security patches, they know it will be an uphill battle against the board. It always is, right? They understand that they need to take down the system—and all the ramifications that come with taking down that EHR system. The IT staff shows up at 3 a.m. to impact the fewest clinicians. Then IT prays that everything goes without a hitch so the system can be back up by 5 a.m.
How do hospitals prepare for planned downtime?
Priscilla: While the system is down, nurses and doctors can’t rely on the EHR for information about patients, their medications, and their conditions. They typically run reports for hours in advance to prepare for the downtime, which removes them from their everyday work.
The IT director is tasked with predicting how much downtime to request. This is tricky, as the time is based on guesstimates from software or hardware companies on how long it will take to complete the update. IT needs enough time to do the update but also to make sure everything came back up correctly before allowing users on the system. They know clinicians will not understand why they need so much time. And they also know they’ll need to have the conversation again in six months, if not sooner. These are just some of the thoughts going through their minds when you bring up the “D” word.
You both work closely with hospitals using Pure solutions to power MEDITECH EHRs. What are some of the unique problems that MEDITECH customers face when it comes to downtime?
Chris: MEDITECH has worked really hard on keeping the system up, rather than preparing for when the system comes up. They’ve worked to certify Windows Server Failover Cluster so customers can stay up-to-date on Microsoft security patches. MEDITECH also has a high-availability solution for non-stateless servers that allows a DNS round-robin-like approach for those updates.
But MEDITECH hospitals do need to bring the system down for MEDITECH software updates. This can be extremely costly. If the hospital stops, the money stops. Studies have shown the average hospital can lose up to about $250,000 for every hour it’sits down. When you have multiple facilities on one system, it can be more than $1 million per hour. These planned downtimes can be required quite frequently, so hospitals need to have solutions in place when a MEDITECH system is down.
How can Pure help MEDITECH customers with planned downtime?
Chris: If a MEDITECH customer has Pure, they’re already aware of our non-disruptive updates (NDUs), which make planned downtime as it relates to storage is no longer a concern. Organizations that aren’t using Pure need to worry about multiple planned downtimes for their storage and EHR.
Pure has a solution to make that maintenance window a little smaller. At Pure Storage, we care about the solution as a whole, not just the storage. So when approached about the dilemma and costs associated with running the hospital during a MEDITECH planned downtime, we knew we needed to find a partner that could help solve this problem.
Priscilla: We didn’t need to look far outside the MEDITECH community to find a company that has taken the sting out of downtime. IPeople has been delivering a downtime solution to MEDITECH customers for many years called IPeople Offline.
Chris: IPeople Offline takes 100% of the hospital’s MEDITECH data, stores it on a single SQL Server, and provides a great user interface to access the EHR data. The result is that during a planned downtime, clinicians can find the information they need to continue performing their patient care responsibilities. This solution has a very light footprint and it can sit on the same Pure Storage FlashArray™ as the MEDITECH system. Most IPeople customers continue to use this product during normal operations because they appreciate the layout and how quickly they can retrieve information.
Priscilla: Planned downtime no longer needs to be scary, nor does it need to stop all hospital operations. Together, IPeople Offline and Pure Storage can help keep the hospital up and running!
Listen to Curing Hospital Downtime on The Pure Report podcast: