A recent EHR crash at Sutter Health was managed in about the same (ineffective) way as most of the other similar health system disruptions. Sutter disclosed little about what was happening during and after the crash. The outage was discussed in a recent article (see: How a Major Computer Crash Showed the Vulnerabilities of EHRs). Below is an excerpt from it:
The...[recent] communications outage at Sutter Health, the largest health system in northern California, which cut off access to electronic health records (EHRs), highlighted the frequency of such outages and the need for backup plans and drills nationwide (see: Sutter Health fixes systemwide computer failure, launches investigation). The outage started at about 10:30 PM May 14 and lasted more than 24 hours, until Sutter announced systems were up and running at 2 AM May 16. During the shutdown, some elective surgeries were rescheduled, some procedures were delayed, and some patients were discharged. The 24-hospital health system executed its downtime plan and reverted to paper-based charts.....Sutter spokesperson Dean Fryer told the San Francisco Chronicle that the cause for activation of the system was not a fire or data breach but did not disclose details. Fryer told Medscape Medical News he would have no further comment beyond the May 16 update.
First of all, let me speculate about why I think that health systems tend not to be forthcoming about their EHR disruptions. First and early in the process, the cause of the crash may be unknown as it is investigated. However, this does not explain the lack of information after the cause has been diagnosed but before the problem is corrected. Secondly, hospital officials do not want to unduly alarm patients by discussing problems of this kind in detail. However and drawing an analogy to delayed airplane flights, consumers and patients can be more alarmed by the lack of information than by releasing accurate updates about the problem. Thirdly, I suspect that hospital executives may be restricted by EHR contracts from explicit explanations about failures. Fourthly, the health system may believe that the release of any significant information will reflect poorly on the quality of the health system itself.
It's important to note that hospital EHR crashes are common. Here's a comment on this point from an article on the topic (see: Electronic medical records: preparing for the inevitable crash):
All ...[major hospitals] use electronic medical record (EMR) systems, and all were left scrambling to function when their system crashed. If multiple hospitals use the same system, the scale of the problem is even larger when an outage occurs. “A computer system lets you do and control more things at once,” says Dean Sittig, a professor in the School of Biomedical Informatics at the University of Texas Health Science Center at Houston. “But when it goes down, you can have bigger accidents.” Sittig and two colleagues recently completed a study, as yet unpublished, of how often EMR systems fail. They found that not only are system crashes common, they are pretty much inevitable. The public is probably unaware of this, suggests Sittig, because news of a crash tends to escape a hospital’s walls only when a ticked-off patient calls a reporter.
The solution to this problem, at least to me, is obvious. Hospitals need to create and publish a standard operating procedure (SOP) for communicating with their staff and patients at the time of any significant EHR disruption. Such an SOP would require frequent updates and include an explanation of the possible cause of the crash, what efforts are being taken to correct the problem, what services have been lost, what steps are being taken to provide the lost services in some other way, and when the lost services will be restored. I suspect that healthcare systems would never adopt such a policy of their own accord so the various regulatory organizations might need to compel them to do so. Until such an approach is adopted, we will continue to remain in the dark about these increasingly common events.