University Hospital Implements Electronic Medical Record Downtime and Disaster Recovery System
ASG-Cypress ensures that patient records are always available and accessible.
“We are known and respected in the health information technology (HIT) community for our success at complex HIT implementations. We were invited to co-present our down-time solution as implemented by ASG-Cypress at the annual Eclipsys User Network meeting. We are very happy with ASG-Cypress and are more than happy to discuss the solution among our peers."
—Director of IT, Clinical Systems Operations.
The Challenge
With more than 2,500 students, 733 resident physicians, and 9,600 employees, including nearly 1,150 physicians providing medical care to patients, this university teaching hospital is committed to providing excellent care to its patients and health information technology to its caregivers.
The clinical systems team was preparing to roll out an upgraded Eclipsys® electronic medical record (EMR) technology to help the hospital move quickly towards digitizing all patient data. The upgraded EMR system promised to improve patient care coordination and outcomes, but what would happen in the event of a catastrophic system failure?
“The clinical systems needed a back-up solution
to deliver critical patient information to caregivers if
their EMR system should ever go down.“
— Clinical Systems Analyst
The team quickly reached a key decision point—whether to give clinicians the patient data in a document format such as PDF or try to recreate the exact visual experience in the down-time system that they would encounter in the EMR system. Recreating the EMR experience would have required replicating the production system and workflow processes on local PCs— an expensive and time-consuming process with many technical hurdles. The clinical systems team instead decided to provide a down-time system experience that would:
- Be flexible enough to enable a variety of access methods based on type of failure
- Be consistent under any and all down-time scenarios—power out, network out, systems down, generator power only, etc.
- Deliver content in a familiar format that would always appear identical regardless of access method or down-time issue, enabling clinicians to focus on the patient rather than deciphering information
- Parse reports from the EMR system, sorting and distributing them in a way that was scalable, robust, and consistent
- Give management proactive notification of breakdowns
Ensuring immediate access to critical clinical information under any circumstance was essential to the safety of the hospital’s patients, so the team weighed the choice and implementation of a down-time solution very carefully. The Eclipsys EMR project manager provided a list of 12 hospital customers along with background information on each EMR project. With their own requirements in-hand, the team interviewed each hospital on their EMR implementation and back-up solutions to ensure they had a 360° view.
The Solution
The clinical systems team based their search on their own requirements as well as the results from hospital interviews. While the interviewed hospitals had implemented a variety of solutions for handling their EMR down-time, a number of them had successfully implemented ASG-Cypress for this purpose.
This hospital chose ASG-Cypress in part on strength of other hospital recommendations, and, in part, because once they saw ASG-Cypress in action, they realized that it would provide the consistency, flexibility and scalability that they required in the event of a catastrophic failure. In addition, the ASG-Cypress implementation team could meet their tight project timeline.
To further validate the ASG-Cypress EMR Downtime and Disaster Recovery System, the ASG-Cypress team conducted an onsite proof-of-concept in February. The hospital’s solution went live in April—a 60-day implementation. ASG-Cypress was tasked with ingesting 18 substantial patient reports hourly, then parsing, sorting, and delivering PDF files to more than 40 separate hospital units and 80 separate computers. If the EMR system went down, these files would be the only available records for clinicians to make critical patient care decisions.
“The ability to ingest massive, complex reports,
parse them into small, specific, manageable pieces
(by individual patient and by hospital unit to name just two),
and deliver them exactly where and when they were
needed was a key capability. We would not be able
to do that without ASG-Cypress."
— Clinical Systems Analyst
"The ASG team was a joy to work with. The ASG-Cypress systems architect was very outgoing, very responsive. He still responds to emails and questions, long after the project has been completed. The whole team had a great level of experience.”
Measurable Results
The hospital’s processing environment required exceptional commitment from both the hospital and ASG-Cypress teams. ASG-Cypress customers typically export a variety of file formats depending on need, including TIF, ASCll, HTML, and PDF. However, the hospital’s environment required that reports be delivered exclusively in PDF format—at a run rate of 1,000 PDFs an hour, distributed to more than 80 devices. In addition, the page count within these documents exceeded 9,000.
The hospital’s implementation team developed an efficient web delivery interface for clinicians to access down-time patient data. ASG-Cypress breaks out reports by patient and by unit and delivers the PDFs to the hospital's secure web server. Clinicians can quickly access a record for all patients in their unit or for a specific patient. They don’t have to scroll through a massive report on all current patients to find the clinical information they need. ASG-Cypress’ ability to parse documents any number of ways based on very specific criteria and then deliver them to a variety of destinations saves the hospital's clinicians tremendous time and effort and helps them provide the highest quality of care.
“The truth is, we’re using a very, very small subset of
ASG-Cypress’ available functionality. And yet, Cypress, in its current implementation, is a critical piece of our ability to function in all EMR down-time scenarios.”
— Clinical Systems Analyst
Currently, more than 5,500 physicians, nurses, and other clinicians access the ASG-Cypress EMR Downtime and Disaster Recovery solution system in this hospital. The top three reports that ASG-Cypress processes hourly total more than 7,500 pages — one is more than 500Mb in size. The hospital has begun integrating physician’s and nurse’s documentation, so these reports are only going to increase in size. The clinical systems team would like to incorporate even more information from the EMR system such as health and progress notes. They see more opportunities outside of the "EMR project" to automate routine reports. The team is working with ASG-Cypress implementation experts to tune the system and accommodate their growing needs. In addition, although ASG-Cypress was chosen as a down-time and disaster recovery system, the hospital’s team quickly realized it is a critical production system. It delivers critical patient information when clinicians have no other method to access it; so, the solution’s reliability is vital. If ASG-Cypress and the EMR system are down, clinicians must rely on patient information that may be hours old. Consequently, the hospital is now implementing additional functionality for ASG-Cypress in its environment.
