Software Solutions/EHR

Electronic Data Loss: Have a Response Plan Before it Happens

By John Todd Cornett, OD

Data loss happens. In an instant, vast amounts of vital records can disappear, but you cannot afford an interruption in service to your patients. Before a catastrophe strikes, you need to develop protocols to deal with sudden data loss.

We all know what to do to treat our patients when things go well. However, what do we do when everything falls apart due to a technological melt down?

One year ago, our practice encountered just such a problem. We are a five-optometrist practice. We rely heavily on technology throughout the office. We are diligent about maintenance and backup systems for our server – or so we thought. On September 16, 2010, at 2:13 p.m., we learned otherwise.

At just that moment, in the middle of a busy day seeing an office full of patients, our server experienced what we would later learn was a catastrophic failure.

Call IT Professional;
Don’t Try to Fix Yourself

It’s tempting to try to fix technological problems yourself, but in the case of a computer hard drive meltdown in your office, it’s not a good idea.

Trying to fix a computer problem yourself could result in you inadvertently making the issue harder for an information technology professional to fix.

Keep an IT emergency number handy at your front desk, and instruct all staffers to call that number if a computer crisis arises rather than trying to fix it themselves.

We were forced to rely on our backups to help us recover. Incredibly, our backups were corrupt going back to June 16, 2010. That was three months of patient data, billing history, schedules and prescriptions–gone in a blink. Thousands of patient examinations were gone. Hundreds of thousands of dollars of billing history was nowhere to be found.

HIPAA Requires
You to Secure Patient Records

Securing patient information in the face of a technological crisis is not just the right thing to do–it’s the law.

According to the Health Information Privacy Act, doctors are required to not only keep patient information private, but to also secure that information.

Click here to learn more about your obligation to secure patient information.

During the 24 hours that followed this techno-error, we combed through files on the way to being shredded, worked with outsource technological partners who back up our systems every day, and over the next few days, we were able to piece together much of what we lost.

Here are the lessons this experience taught us:

Stop and take a moment to understand that, while things may be bad, you will get through. No one has received a terminal diagnosis. Keep your wits and sense of humor about you. Your staff will take their cues from you. Now is the time to lead well.

Don’t do anything at this point that could jeopardize your recovery. Have the experts come in quickly to assess your situation to be sure you don’t do something to make your recovery harder.

Dumpster dive and unlock the shredding bin. There is an enormous amount of very usable data that goes out the door as trash. Collect your trash from the dumpster if you can. Unlock the bin you have for shredding. You will find a treasure trove of useful data.

Call vendors. The labs that you use will have data about orders you have made. Also, contact lens companies will have some record of diagnostic trials you have ordered. Call and retrieve as much information as you can from those sources.

Look to services you outsource for data recovery. We utilize an outside service that will confirm our schedules and do recall. Fortunately, they take daily snapshots of our schedule as far ahead as six months into the future. This was without a doubt the most helpful data we were able to retrieve. Because they confirm our schedule daily, we were able to rebuild most of our past schedule. More importantly, we were able to know who was coming in. Without that data, we were blind to who was on our schedule for any particular day. That loss would severely impact our ability to schedule additional patients and deal with the patients who knew they had appointments.

Be upfront with patients. Tell patients the truth. For the majority of patients, we lost a limited amount of data from one of their exams. Almost everyone understands that data loss is a potential issue with computers. Patients are sympathetic. Despite what we were told and believed to be robust backup systems, we lost data. Most patients were understanding and helpful.

Understand you lost some data, not everything. The emotional toll on you and your staff is enormous. You must keep those emotions in check early and often. Essentially, we lost parts of one encounter with some of our patients. We did not lose everything. At times, it did feel like we lost everything. We had to stay positive. Had we used paper charts and experienced a fire or a tornado, we would have lost everything related to our patient charts. In this case, we lost some of that data.

Look at your automated instrumentation. Most of your automated equipment will have local storage. That is huge. We were able to find auto-refractions, topographies, Optomap images, OCT scans, and visual fields from all of our patient encounters. In essence, we lost some of the interpretive data but not the raw data. This was another major help in getting us through this period of time.

Coach your staff. Your staff looks to you for leadership. This is the time to lead by setting a positive tone. Coach them in what you want them to tell the patient and how you want things stated. If you don’t, they will get tired and paint a more dire picture for your patients than is necessary. Keep them positive and upbeat. At some point, you must stop trying to recover and restore lost data. The yield from extraordinary measures will no longer be worth the effort. Your staff will be exhausted as well. After about three or four months, we turned off the switch on the recovery of data–particularly financial data. That was a relief for everyone to know that we were turning the corner as best we could.

Contact third party vendors. Many of your insurance companies may be able to help you recover your prior billings to rebuild patient financial data and records. Call them to see what information they can share related to your prior billings.

Call your bank. Your bank can be an amazing source for the recovery of financial data. We were able to get images of every patient check that they processed for us. That allowed us to rebuild deposit information much more accurately.

As with most things in life, we are only as good as our weakest link. When that link snapped in our office, we were able to recover and maintain the same trajectory of growth we had been experiencing. Our staff learned some valuable lessons in teamwork, perseverance and dedication. We learned the importance of remaining positive and setting a great tone for the office. We were able to demonstrate to our patients that our commitment is to take great care of them at all times–even when bad things happen.

Technology will fail, but if we handle these situations properly, we can reaffirm our relationship with patients, and establish better protocols for handling future techno-crises.

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John Todd Cornett, OD, is a partner with Premier Vision in Amarillo, Texas. To contact him:jtcornett@amaonline.com.

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