How To Use Your Hosted EHR When the Internet Goes Down

In 2002, if you would've asked a physician if they wanted to host their electronic health record in a server farm somewhere out on the internet, 9 out of 10 times you'd be told to take a hike. Who trusts the Internet's ability to allow you access to a server you can't see to provide you with every piece of clinical information you need to treat a patient anyway? Since 2002, the comfort level with allowing sensitive information to live on computers hundreds or thousands of miles away has significantly increased. Online banking and investing, online taxes (TurboTax), online lead generation (Salesforce), hosted email, etc. has opened up a whole new world of possibilities when it comes to trusting that information will be out there on the internet when you decide you need it.

The same goes for electronic health records. The key difference is that if you can't access your bank account, taxes, or email, you might be willing to wait a few minutes or maybe even a few hours....but with a patient, you need information at your fingertips in order to make sound clinical decisions, and you need it now. So when considering the prospect of using a hosted electronic health record, it's important to learn the sure-fire ways to decrease or maybe even 
eliminate the potential for inaccessibility.

Redundant Internet Connections
This is crucial. If you use a Comcast cable connection to get out onto the internet, order a backup DSL line just in case. You can buy a router that automatically detects an outage and reverts to the backup internet connection. You'll want to hire the right local IT group to set this up and support it but it's fairly inexpensive (<$100/mo.) and can solve your connectivity problems before they even begin.

Wireless Internet
You could even take it a step further and buy a wireless internet card from Verizon, Sprint, AT&T, etc. You used to have to buy a seperate account for each one of these cards and pay monthly but nowadays you can find wireless routers like the Kyocera KR2 that can take that cellular signal and broadcast it within your office for all to use. It isn't the fastest connection, but it'll do the trick. The carriers may say they don't support this approach, but luckily they don't need to.

The nice thing about these wireless signals is that even if the power went out in your office, you could have this router on a cheap battery backup and keep seeing patients (if you have enough natural light to see them) using a tablet PC or laptop. Very cool.

Print to PDF
Some companies are even coming out with mechanisms designed to deliver PDF reports to a PC at your practice just in case. These PDFs can be set up to deliver a schedule of all the patients you plan to see in the next two weeks, and continue to update those PDFs as time goes on, so you always have at least a few days worth of information locally. All you need is a PC that everyone in the office can access just in case of internet failure. Solutions like Galen Healthcare's VitalCenter does exactly that. It's a great add-on solution to any remotely hosted EHR and should near eliminate concerns over internet downtime. Below is their presentation on how it works:

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