The Myth of the Nines: What Happens When the System is Unavailable?

You may have the most advanced, state-of-the art technology installed, and a crack team of IT people to support it, yet downtime is inevitable. Yes, systems need to be brought down on purpose for maintenance or upgrades. But, there are the times when you-know-what happens (as Murphy’s Law ensures) and your system goes down. It could be a network or power outage, or a natural disaster such as a severe thunderstorm, hurricane or tornado. It could even be that your state-of-the art system has failed for some reason.

A study conducted by Gartner found that organizations experience an average of 87 hours of system downtime annually. That’s an average of 1.6 hours of system downtime per week. Because of the tremendous reliance on technology to perform day-to-day tasks, a system downtime can have an impact on processes, either slowing them or stopping them altogether.

So, what happens in your organization when the healthcare information system is not available? For one thing – you are no longer capable of Meaningful Use.  More importantly, because your staff is so dependent on the system, they cannot perform their jobs as usual. For hospitals, any impact on business continuance potentially threatens patient care, as systems are necessary for accessing, retrieving and sending critical data that is needed for treating patients. Therefore, hospitals need to do what they can to ensure business continuance, starting with having a plan for how the organization will continue operations when any critical functions are interrupted.

Myth of the Nines

There is an implied assumption, called the “Myth of the Nines,” that if your systems are operating 99.999 of the time, then your business is operating 99.999 of the time. This is not the reality, because 1.) Even 99.999% means some downtime in a 7/24 operation; 2.) Uptime statistics typically do not include “scheduled” downtime; and 3.) After an outage, your staff has to try to catch up on lost time and shelved tasks, and enter data that had to be recorded on paper during the downtime.

Also, people fail to understand that business continuance is not just about surviving a downtime or some disaster. It’s an everyday concern. It isn’t just system or power outages that can cause downtimes. Minor glitches can always rise up, or individual applications can go down or access to them can become temporarily unavailable. For example, eMARs may not be functioning properly, or the pharmacy application may be down, which means no one has access to the eMAR and can find out what meds a patient is taking or how much and how often.

Any single point of failure can create a ripple effect. It’s these smaller, typically unreported incidents that can have real impact on hospital operations and create a need for business continuance. Thus, you need to identify all of these potential little disruptions to your overall system (and business operations) uptime.

As hospitals users embrace on-line utilization of more and more clinical applications, their increased reliance on technology will make it more and more difficult to continue patient care if the system or systems are unavailable. What business continuance really comes down to for hospitals is ensuring the necessary data is where the patient is. So the question is: Do you have a downtime contingency plan in place that is workable and easy to implement, or are you compromising? We’d like to hear from you.

Posted in Business Continuity, Healthcare Information Systems.

Arthur Young is a visionary healthcare information systems entrepreneur who has focused Interbit Data’s offerings on providing secure and reliable methods of connecting users with HCIS information. Prior to founding Medical Systems Solutions (the precursor to Interbit Data) in 1997, Arthur spent 10 years with MEDITECH and three years at JJWild.

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