'Our entire electronic and data system failed'

Nurses want probe into EMR failure

By Erin McCann
11:23 AM
Nurses at a California hospital are asking state officials to investigate the failure of the hospital's electronic medical record system, an incident they said led to the closure of its emergency room and compromised patient safety.
The EMR system at the 420-bed Antelope Valley Hospital in Lancaster, California, reportedly failed last weekend, resulting in clinicians unable to review patient labs, verify physician orders and access patient records, according to the California Nurses Association and the National Nurses United union. 
"Our entire electronic and data system failed," Feb. 27 wrote Antelope Valley's Maria Altamirano, RN, on behalf of California Nurses Association, in a letter to the Los Angeles County Department of Public Health. Due to the failure, the hospital, Altamirano explained, had to close its emergency department because it failed to have adequate backup plans in place. 

"How many hospitals are compromising the lives of their patients by not having a back up or plan of action in place for a catastrophic event as this?" she asked.

The hospital's pharmacy system and its backup also crashed, according to an emailed statement from a CNA spokesperson.  
However, according to hospital officials, downtime procedures were indeed in place and utilized, said Dennis Knox, chief executive officer at Antelope Valley Hospital, in an emailed statement. When the EMR outage occurred Friday, Feb. 27, hospital officials took immediate steps to bring the system back online. The system was fully working again on March 1. 
Clinicians were able to resort to hand-written medical record keeping, and despite the EMR being down, the hospital was still able to process medication orders and lab results, Knox explained. What's more, although medication requests were processed via hand-written paper orders, the prescription management system was on a server unaffected by the outage, and thus the pharmacy could continue filling those orders. 
Knox acknowledged that there were times during the outage when they had to send certain patients to nearby facilities for treatment, but its emergency department did continue to treat patients. 
"Our team of professionals worked tirelessly throughout the weekend to process lab orders and results, review radiology exams, carry out treatment plans and deliver overall patient care as promptly as possible," added Knox. 
National Nurses United, the largest registered nurses union in the U.S. with some 185,000 members, in the last few years has criticized specific hospitals' use of EMR systems, platforms that have significant downtime, fail or are not designed well for clinician users. 
As NNU Spokesperson Liz Jacobs told Healthcare IT News back in 2013: "We're not anti-technology." Rather, "we want smart technology that embraces and includes the clinical expertise of a registered nurse who really knows how best to put together a system that will work for them."
The union also spoke up in a similar EMR outage back in August 2013 when Sutter Health's $1 billion EMR system went dark for a day, preventing clinicians from accessing patient medical records and seeing medication orders. 
"This caused intermittent access challenges in some locations," said Sutter Health Spokesperson Bill Gleeson in an emailed statement to Healthcare IT News of the incident.