Ready for Downtime: Preparing for Unexpected Internet and Power Outages

Downtime refers to when a clinic or health care system's electronic or physical operations are disrupted. Downtime due to planned maintenance is usually brief and easy to plan around. But when it is caused by cyber-attacks that leave clinics without access to internet-connected systems, or natural disasters that damage physical infrastructure, the disruption can be much more severe.^1,2

Cyberattacks against health care organizations are on the rise, and anti-viral software with security protection is not capable of blocking every incursion.³ Hospitals and larger health centers may have backup generators to provide power during a weather emergency, but smaller ambulatory clinics usually do not and could be without electricity for hours or even days. Outages can prevent clinic staff from accessing electronic health records (EHR), limiting or preventing communication with patients, other clinicians, and insurance companies. They can make it impossible to retrieve schedules, make referrals, or electronically send prescriptions to the pharmacy.

Proactive preparation for these events can help clinics maintain patient care in a modified way and then restart normal operations as soon as possible after the situation is resolved. This article draws from the University of Florida Health's outpatient family medicine protocols to explain how to create a downtime team, develop downtime procedures, and practice for various scenarios with mock downtime drills.

The first step in preparing for unexpected outages is to assemble a downtime team with expertise in several areas. At a minimum, the team should include clinicians, information technology representatives, nurses/medical assistants, and administrative personnel (e.g., office manager and front-desk staff). One person should be designated the team leader in charge of coordinating response to an emergency and wrapping up the response once systems are restored.