Antelope Valley Hospital on EHR downtime: Data were always safeguarded

“Never was our data in any danger. It was always safeguarded and we gave the nurses all the tools they needed to perform their jobs,” said Antelope Valley Hospital CIO Dale Lepper. Lepper spoke to Clinical Innovation + Technology to follow up on reports from the California Nurses Association that when the hospital’s EHR system went down for 38 hours in February, patient safety was at great risk.

A SANS company stores all of the hospital’s information, he explained, and a redundant fiber channel card went out. That affected the other fiber channel and led to the storage unit being in read-only mode so the hospital could no longer write to that unit.

“We lost the connection. The system did not go down,” he said. Two key components—medication stations and the PACS—never lost communication.

Despite reports to the contrary, the hospital’s emergency department was never closed. In fact, they saw more than 900 patients during the 38-hour period. “I don’t think it impacted our patients in any way,” said Lepper. “This is just part of life in hospitals since we’re open 24 hours a day, 365 days a year. There is no record of any drug errors or bad outcomes and we are mandated to track those, report and follow up on them.”

The local public health department has visited the facility and gathered information about the incident. While Antelope Valley is still awaiting the final report, “all indications were positive,” said Lepper.

The hospital has downtime procedures for both the IT department and each of the other departments, Lepper said. “That’s something we practice throughout the year.” Software updates occur 6 to 12 times a year and last up to 12 hours.

“All this equipment we run on is hardware. The unit in question has a record of 99.99 percent uptime but it’s still an electronic device and it happens.” The vendor went back through its record during triage of this incident, said Lepper, and found only one other similar occurrence over a seven-year period.

The hospital has been using an EMR for 5-6 years, said Lepper, so “it’s fairly new for us. We are in the stages of becoming electronic.” Although they have met the requirements for Meaningful Use Stages 1 and 2, “40 percent of our orders are paper and half of what we do in this building is still non-electronic.”

After all such incidents, the hospital conducts a critique afterward “to see what we can do better. We did the same thing this time including an IT debrief and facility-wide debrief. We’re bringing all those notes together because there are always lessons learned in everything we do.”

Downtime policies, procedures and drills are “for this exact situation. There is no break. That’s why we critique every time to make sure we’re doing the best we can.”