Care of the Critically ill and Injured During Pandemics and Disasters: Hospitals and Health-care IT Preparedness Planning
We suggest hospitals have a plan for rapid movement of the data center to offsite remote operations in the case of prolonged local power disruption for critical functions.
We suggest a plan be in place to provide power to the client machines, analyzers, networking equipment, etc along with the data center for an extended period of time.
We suggest hospitals plan around extended supply disruption of critical IT supplies, such as servers and disk drives. www.medicine-against-diabetes.net
When a disaster directly damages a hospital’s facilities, direct damages to the IT infrastructure are likely, as well as to local utility and transportation networks. Continuity of operations will require both onsite and offsite redundant systems. Hospitals are required to have 72 h of onsite power generation capability; however, although in an extended disaster this is insufficient, extended-capacity systems are not required by the Joint Commission on Accreditation of Health-Care Organizations and are unlikely to be installed because of current financial pressures on hospitals. If local transportation networks are affected, difficulties may occur in obtaining sufficient quantities of diesel fuel to run generators as well as transport fuel where it is needed.
In addition, supply chain interruptions may affect hospital IT functions. The floods in Bang-Pa, Thailand, in 2011 impacted worldwide availability of hard drives, as all three hard-disk world manufacturers are located within a kilometer of each other; although one of the manufacturers was spared, the flood still resulted in a 66% reduction in worldwide hard-disk supply overnight and a 2-year period of insufficient supply. Stocking of IT supplies should be done with the knowledge that they have expiration dates mainly due to compatibility and performance.
We suggest hospitals and health systems maintain an inventory of all computer systems, especially servers and memory storage capacity (disk drives), with a predefined hierarchy of “most-to-least important” in terms of continuity of patient care and financial operations. In extreme shortages, lower prioritized systems may increasingly be repurposed as needed. Hospitals should also consider maintaining stockpiles of critical IT equipment.
Continuity of operations requires effective preparedness planning and is a daily occurrence in health care. Routine challenges to normal day-to-day functioning should provide experience and expertise necessary in contending with similar, although bigger, issues in an actual disaster. Planning and preparedness for daily and disaster-related medication and medical supply shortages will be more effective with a focused strategy using the six steps outlined in this manuscript.
IT disruptions affect all aspects of patient care, but with disproportionate impact on those patients who are critically ill. IT preparedness should include the ability to urgently reestablish local area networks with available power, use portable hardware, plan for each patient’s portable database, and protect patient’s information privacy. Concurrent planning for prioritizing server and memory storage needs and requirements will increase longer-term preparedness to support clinical and business operations.