Downtime procedures for a clinical information system: a critical issue

As computers become embedded in clinical workflow processes, disruptions to access can have serious consequences. The Health Evaluation through Logical Processing system at LDS Hospital is a computerized hospital information system that has been under continuous development for more than 30 years. The system maintains a 99.85% uptime and averages more than 17 000 logons per day. The first formal downtime plan for this system was developed in 1992 in anticipation of a major hardware installation. In early 2000 after a series of planned downtimes from which we did not recover smoothly, our Software Oversight Committee became interested in understanding downtime procedures. A downtime plan for clinical users was developed and tested and is discussed. A March 2000 downtime survey of 103 clinical staff provided additional information to refine the plan. The downtime plan now includes explicit instructions about the clinical data that must be reentered after a downtime and also includes a plan for a regularly scheduled downtime practice drill similar to a fire drill.