What to do (and what not to do) when your $1B system-wide EHR fails

Sutter’s 241-bed Mills-Peninsula Medical Center in Burlingame, Calif.Sutter’s 241-bed Mills-Peninsula Medical Center in Burlingame, Calif., was one of the Sutter locations that experienced system failures.

'There really wasn’t any support from management on what was going on.'

The 24-hospital Sutter Health system in Northern California was the talk of the town late August after a software glitch rendered its $1 billion Epic electronic health record system inaccessible to nurses and clinical staff throughout all Sutter locations. 

On Aug. 26 at approximately 8 a.m., nurses, physicians and hospital staff had no access to patient information, including patient medications and all vital patient history data, according to reports from the California Nurses Association, part of National Nurses United, the largest nurses' union in the U.S. 

"Many of the families became concerned because they noticed the patients were not getting their medications throughout the day,” explained Mike Hill, RN at Sutter’s Alta Bates Summit Medical Center and CNA representative for the hospital. "Meds were not given for the entire day for many of the patients."

Officials at Sutter Health confirmed the outages. On the morning of Aug. 26, "we experienced an issue with the software that manages user access to the EHR," wrote Sutter Health spokesperson Bill Gleeson, in an emailed statement to Healthcare IT News. "This caused intermittent access challenges in some locations."

By some reports, the issue was caused by a Citrix glitch, but Sutter officials wouldn’t confirm the vendor. The Sutter Health IT team applied a software patch later that night to resolve the issue and restore access. "We regret any inconvenience this may have caused patients," said Gleeson, who added that throughout the glitch, the "EHR was live," despite users being unable to access it.

Hill said it caused more than inconvenience, as "everything went down including the backup." Even when nurses attempted to use the health system’s Pyxis medication management system to print out patient information, the data was outdated by two to three days. "The nurses basically were operating blind that day," Hill added. 

[See also: Setback for Sutter after $1B EHR crashes.]

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                                         "Everything went down including the backup."

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Other readers argue that Sutter responded swiftly and efficiently. Reader Anish Arora, founder and president of healthcare IT consulting firm Afyatech and has worked with Sutter before, said, "No time was lost, no stone left unturned to fix the problem as quickly as possible."

Days earlier, the EHR system was also down for eight hours due to a planned upgrade; nurses could still read medication orders and patient histories but had to record new data on paper to then be re-entered into the system later.

Some Healthcare IT News readers were shocked over this amount of downtime. "The IT department should not even be taking down the EHR for eight hours for a planned upgrade anyway. They need to find a better way to manage upgrades," said Martalli, in a comment posted on the Healthcare IT News web site.

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