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DISASTER
RECOVERY Return
to the Fall 2001 _____________ Corporate President/CEO Vice
President
CONFERENCE REGISTRAR Brazil:
Jose Carlos Ferreira
|
Click Here for a Printable Version Getting
Started In Healthcare Disaster Recovery – by Kathy Lee Patterson, ABCP As a Business
Continuity Planner (“BCP”) or Disaster Recovery (“DR”)
expert, have you had the opportunity to perform a Business Impact Analysis
(“BIA”) for a healthcare provider? Well it doesn’t take
long to realize business is conducted in a far different manner. Hospitals
have a culture all of their own. One obvious difference is that the
healthcare provider is driven by the goal of preserving human life,
with all other business and infrastructure needs a far second. Shortly after
beginning, you will notice the information services (IS) departments
of many hospitals are usually ancillary groups, treated quite differently
than clinical departments. Budgets can be far lower than needed to adequately
support IS initiatives, leaving many systems on the verge of obsolescence.
Additionally, clinical departments often operate autonomously, purchasing
proprietary systems from vendors without IS knowledge or input, and
subsequently expect IS to maintain the equipment after the vendor departs.
Only within the past 5 years have clinicians come to realize the importance
of their computer systems, applications, and email and how these systems
aid in providing patient care. The exciting
fact is that HIPAA has started to “wake up” the healthcare
community to the importance of disaster recovery. Last year
I was asked to develop a comprehensive IS based DR Plan for a major
teaching healthcare provider. I started out by conducting a Business
Impact Analysis to demonstrate to the institution what impact a disaster
would have to the care giving ability, finances and community support.
It didn’t take long to realize that asking the typical BIA questions
would not ascertain the true impact a disaster would have on these hospitals.
If you are
initiating a BIA for a health system or hospital that you are not familiar
with, I strongly recommend that you obtain assistance from a reliable
representative within the institution to introduce and show you the
territory. Each institution has their own nuances and the sooner you
learn those qualities, the smoother your project will run. You will
save a great deal of time. Many hospitals are set on campuses with numerous
buildings and many of the same departments are divided amongst different
buildings. You will also benefit from the guidance they can provide
in developing the survey questions, keeping you from making any improper
assumptions. Healthcare institutions are very complex in nature and
asking defined questions as to how their departments run will give you
better perspective when presenting the findings. Generally,
in conducting a BIA, one of the major objectives is to find out what
the financial impact of a disaster would be to the institution. In a
clinical environment, this becomes a little more complicated. In a large
healthcare institution, clinical departments may not know how much income
they actually generate. Insurance payments and government regulations
muddy the waters even more. The clinical practices are very familiar
with their budgets and the costs of their required resources, but routinely
have a difficult time quantifying how the absence of their computer
systems would affect their bottom line. A survey of the financial department
reveals they may have the numbers, but not be able to accurately portray
the impact an IS disaster would have on the ability to render patient
care. If you concentrate on securing the qualitative data from the clinical
departments and quantitative data from the financial departments, a
great deal of confusion can be eliminated. Patient management
is the key phrase to understand. In most cases, a patient is rendered
care by a great deal of departments during a typical hospital stay,
such as laboratory, nursing, radiology, food service, housekeeping,
etc. In-flow and out-flow questions are extremely important to calculating
impact. For example, when scheduling an interview with a food service
department, I was advised that they are not very important because they
didn’t generate income and therefore didn’t feel they needed
to participate in the analysis. Even though Food Service doesn’t
directly charge for in-patient meals, by law, a hospital will not remain
open very long if they cannot feed their in-patients. They are extremely
reliant on their computer systems to compile the patient’s food
requirements for each meal. Their inflow comes from in-patient departments
via the network and their computer applications, and their outflow is
the food that sustains lives and allows the hospital to remain open.
Conducting
detailed interviews is crucial after you have reviewed the completed
surveys from every department. But be warned -- have your questions
ready and be prepared. As soon as a clinician feels you are wasting
their time and the questions are not relevant to them, you will immediately
be shut down and the interview concluded. Most clinicians will work
regardless of whether or not the computer systems are functioning. One
out-patient surgical department explained during an interview, that
if they suddenly lost their critical applications and computers, they
(1) would not know who was coming in that day for an appointment, (2)
would not have their charts ready when they got there, and (3) probably
would not be able to bill them effectively, but they would still feel
compelled to provide their patients with the best care possible anyway.
While you will surely agree that this is admirable, exactly how would
you gauge the impact of a loss of the computer systems? Well, here
are a few questions that helped me squeeze the information required
for my analysis from them: After extrapolating
this customized information from your participants, you can add the
typical BIA questions to your survey. Don’t just assume that all
departments are 24 x 7. Many supporting departments are only open for
business between 7 a.m. to 7 p.m. or other hours. As in any
BCP/DR project, senior administrative support is essential. Make the
survey participants aware at the onset that senior management wants
their department to participate in this project. A signed statement
of support from the CEO will get you farther faster. If time does
not permit you to survey all the departments that make up a health system
(there could potentially be more than 100 separate departments), divide
the departments in three categories: Clinical (renders patient care),
supportive (to the clinical departments), and corporate. In doing this,
you can make sure that you are getting equal amounts of responses from
the three categories, keeping your data more accurate. If you have the
benefit of using a survey software product as I did, the data collection
process far more accurate and efficient. After you
have compiled all of your data and are ready to present your report
to senior management, it is important to remember who your audience
is. You are working with health care providers and to them, patient
care is paramount. If you speak only in technical terms and financial
impact, you could easily lose their attention and further plans for
development could be refused. Take the time to explain what a hot site
is and how it is used; they will greatly appreciate it. You have to
cross the business barrier, speak in their language and to their emotions.
Mention the amount of hours it would take before patient care is inhibited,
how many hours before public confidence would be jeopardized and when
staff productivity would begin to slip. A simple example is the Admissions
department. When a hospital admits a patient, insurance carriers need
detailed information for pre-certification purposes within a 24-hour
window. If your computer systems are down for one week, you might be
able to admit patients and render care, but run the risk of not getting
paid for your services. When you put it into those terms, you are far
more likely to get buy-in from administration. The BIA was a great learning process for the entire healthcare community. Since most of the departments are focused primarily on patient care, they never took time to think about how they would function without their computer systems and applications being unavailable for a long period of time. Many participants noted that they would give more attention to better work-around procedures, in-flow and out-flow procedures and necessary back-up procedures (which all tie into the new HIPAA regulations). Your training and awareness has now begun and your Disaster Recovery project is on its way. Hopefully, if guided appropriately, healthcare professionals will embrace the importance of disaster recovery incorporating BCP into their healthcare mission in the future. Kathy Lee
Patterson, ABCP, is a Healthcare Disaster Recovery Specialist for the
Healthcare Solutions division of Affiliated Computer Services. ACS offers
innovative and effective outsourcing solutions for clients worldwide
To learn more about ACS, visit www.acs-inc.com. *To comment on this article, go to 1404-10 at www.drj.com/feedback.
©Copyright 2001 Systems Support Inc. All rights reserved. Reproduction in whole or in part in any form or medium without the express written permission of System Support Inc. is prohibited. |
