From natural disasters like floods and hurricanes to technical ones like hackers and malware. the healthcare industry has a unique responsibility to prepare for the worst in order to protect patient data and provide patients with critical services with as little downtime as possible.
This means that healthcare organizations need a plan and the right technology to provide both business continuity and clinical continuity in cases of service disruption. Many organizations have long had a business continuity plan, ensuring that a backup copy of each image is archived in storage, historically for legal purposes. That medical image archiving typically occurs on tape or disk; the data is there, but not easily accessible.
The inaccessibility of backup files poses a significant problem for clinical continuity--the ability for a clinician to retrieve a medical image or other data for use in the diagnosis and treatment of a patient. It's the time lapse between clinical need and accessibility when there is a service disruption that is most critical in the modern EHR environment.
It's important to note that achieving HIPAA compliance does not ensure that an organization will be able to provide adequate business and clinical continuity in a service disruption or disaster. However, technology--in particular cloud-based storage and services and medical imaging mobile viewers--can help bridge the gap.
The data tsunami adds complexity to disaster planning
Picture archiving and communication systems (PACS) have reportedly grown at a rate of more than 20% annually in recent years, according to business research and consulting firm Frost & Sullivan, meaning that for every year that passes, disaster recovery solutions become even more complex. As noted by Frost & Sullivan, "The exponential growth of data spurred by EHRs and, especially, imaging systems means (disaster recovery) projects are a big challenge."
Adding to the planning complexity are HIPAA security standards for regular testing of contingency plans that in 2009 were extended to apply to providers' business associates. This change makes it critical that providers are familiar with not only their own internal measures, but their vendors' contingency plans too.
Prepare for the "small" disasters too
Most organizations plan for the major disasters, such as catastrophic natural events, fires or power outages. Yet many more common service disruptions come from technical issues, such as network failures, hacking or malware.
Any contingency and continuity plans must not only include strategies to avoid service disruptions in the first place, but also to get the provider back up and running as soon as possible.
The cloud can provide business and clinical continuity
Healthcare organizations have traditionally provided their own in-house data storage and management systems, partly because of budget constraints and the perception that in-house servers are safer and offer faster access to patient data. Yet in-house systems require ongoing capital investments; growth and scalability of these systems can be inefficient, costly and downright risky.
When medical imaging is in the cloud, an organization can arrange to have the provider assume some or all of the responsibilities that the organization must perform, including responsibility for security measures, the management of upgrades, backups and support for disaster recovery, and business continuity that is compliant with the HIPAA Security Rule. An organization's use of the cloud may include a contingency plan that covers:
- Disaster recovery
- Data backup
- Emergency mode operation
Regarding PACS, few PACS deployments have a backup of the complete PACS application in a separate data center that could access the image data if the PACS in the primary data center went down. The benefit of the cloud in this situation is that if a PACS goes out of service, the viewing capabilities packaged with a cloud-based image management system could provide a disaster recovery copy of patient medical images and clinical access to those images. The disaster recovery copy can become a business continuity solution.
Moreover, storing medical images in the healthcare cloud lays the foundation for mobile solutions that allow providers to securely access medical images and reports virtually any time, anywhere on almost any device--critical for clinical continuity after an event like a natural disaster.
Five key benefits of the cloud in a disaster
Many healthcare organizations look at the short-term costs associated with migration to the cloud when they should be looking at the possibilities of a long-term investment with significant return. A vendor-neutral cloud-based environment offers benefits beyond the standard disaster recovery system, such as:
- Data accessibility--A vendor-neutral solution ensures that PACS data can be retrieved as needed, regardless of device or PACS system.
- Security--Data is stored securely and remotely, safely monitored at multiple security levels, from physical to virtual.
- Cost-effectiveness--Storage is scaled on an as-needed basis, eliminating the need to purchase and maintain dedicated storage infrastructure. Factoring for staff, infrastructure and operational expenses, Frost & Sullivan cites estimates showing that cloud-based solutions can cost as little as one-seventh as much as traditional SAN solutions.
- Professional management--Trained professionals handle daily operations, freeing internal IT staff to focus on day-to-day in-house issues.
- Continuity--With a cloud-based vendor, data is available on demand to ensure that business and clinical operations continue uninterrupted.
Best practices for ensuring continuity
When working with a cloud services provider, it's important that the provider has an adequate pipeline, bundling the full capabilities of the network, cloud and mobile services.
A robust network will provide redundancy, rerouting messages as needed in the event of an outage. Vendor-neutral data storage enables the use of mobile image viewers for virtual any time, anywhere access, even if physical damage has occurred within the medical facility.
A partner in preparedness
Disasters may happen, but by working with a top healthcare cloud services provider, organizations can minimize costs, improve continuity and reduce downtime, keeping hospitals running even in the event of a catastrophe.
Barbara White is Director, AT&T ForHealth Cloud Solutions