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I think there are no plans because the risk the backup procedures create is high enough to make it more prudent to just shut down. Miscommunications in hospita
by curryst 6y ago
I think there are no plans because the risk the backup procedures create is high enough to make it more prudent to just shut down.
Miscommunications in hospitals are a significant risk, even with EHR (thus the original requirements for EHR). If we assume a full IT outage, then EHR is effectively a non-option. That means we're probably back to using paper. Except now, no one uses paper outside of emergencies, so the original risk of miscommunication with paper is now compounded by the lack of familiarity with it. That problem is going to get worse over time as the medical personnel who used to work entirely on paper retire and are replaced with younger people who have never worked on paper outside of emergencies.
Redundant systems are also harder to create for IT outages vs generators. Generators are simply providing an alternate source of a basic substance. In IT outages you have to consider supplying alternate sources of substances (Kubernetes is an example, as it manages many sources of CPU and network) as well as circumstances where the well of your substance is poisoned (i.e. someone put an infected file in an S3 bucket, or someone is running SQL injection attacks). Solving the first problem is easy, with things like high availability, Kubernetes, etc. The second problem still seems to be an open question; I've never seen a solution that really addressed it other than to backup frequently and try to make sure that your time to recovery is low.
I think the more sensible solution is to pursue what we're doing currently, and change your SLA from "hospital is available to patients" to "medical service is available to citizens within X minutes". We have redundancy in the form of multiple hospitals. Each hospital should be as reliable as possible, but a hospital failing is inevitable under some circumstances. Then we just need to focus on maximizing the efficiency with which we route patients to hospitals. The article says it took an hour to make a 20 mile drive. There has to be a way to improve that