Section 6.12 Optimize
Contingency Plan Assessment
for EHR and HIE
Use this tool to identify and document all existing backup functions, emergency mode operations,
and disaster recovery plans in existence, and to plan for enhancements as health information
technologies (HIT) systems are adopted.
Time needed: 16 hours
Suggested other tools: Section 1.4 EHR Technology and Readiness Inventory, Section 1.5 HIE
Technology Readiness Inventory
Introduction
Disaster recovery refers to the ability to recover data after a disaster or other interruption of service.
You can use the contingency plan assessment to assess your current contingency plans and to prepare
for enhancements as more mission critical clinical information systems are adopted and replace
paper-based systems.
How to Use
1. The person responsible for contingency planning should complete this form, in conjunction with
the (HIT) steering committee. The HIT steering committee needs to be involved in determining
the criticality of IT resources, data, and applications. Some home health agencies may utilize
companies that specialize in emergency mode operations/disaster recovery planning to develop,
test, and maintain such plans for the physical facility, such as for fire safety. These plans should
be enhanced with backup and business continuity/disaster recovery plans for disruption to HIT.
2. If you do not have physical facility contingency plans, it is critical to assess your HIT
contingency planning needs.
3. If your agency will have its servers hosted offsite, you may just need business continuity plans
for reverting to paper and manual processes in the event of system downtime, loss or failure of an
input device, lack of connectivity, or power outage. If your agency will manage its own data
center, a more robust plan for backup and disaster recovery is needed in addition to business
continuity planning.
4. Complete each of the sections of this tool in sequence, reflecting the current situation at your
home health agency.
5. As your data criticality changes with electronic health records (EHR) and participation in a health
information exchange organization (HIO), evaluate your changing needs. For example, you may
currently back up once a day and have an employee take the backup to the bank’s safe deposit
vault. Once you move to an EHR, you will need fully redundant servers, network capability, and
simultaneous backup. These can be acquired through an information systems host, application
service provider, or software as a service vendor (see Section 1.9 Financial Assessment,
Financing Resources, and Acquisition Models), but there may still be additional costs for other
forms of redundancy, such as for telecommunications/connectivity, input devices, and power. Be
sure these requirements are brought forward as you work on your total cost of ownership and
Section 6 Optimize—Contingency Plan Assessment for EHR and HIE- 1
return on investment planning (see Section 2.11 Business Case: Total Cost of Ownership and
Return on Investment for EHR and HIE.)
Criticality Analysis
Use the following definitions to describe Criticality Level:
•
For IT Resources:
o Remote and fully redundant (with automatic failover and sustainable power)
o Local and fully redundant (with automatic failover and sustainable power)
o Redundant (without automatic failover)
o Backup only (with specified lag time during which data may be lost)
• For Applications:
o Mission critical (impacts patients)
o Critical (impacts productivity)
o Important (manual workarounds suffice)
o Deferrable (minimal impact)
• For Data:
o Private/Sensitive (disclosure adversely impacts patients)
o Confidential (wrongful disclosure has potential to harm individuals or the organization)
o Proprietary (disclosure of business/practice secrets may result in loss of competitive
advantage)
o Public (no harm through disclosure)
Current State
Description
Criticality
Planned State
Planned
Level
Criticality Level
Remediation
IT Resources
Production server(s)
Test server(s)
Back up server(s)
Exchange server(s)
Other:
Input devices
Printers
Scanners
Other:
Telecommunications
devices
Telecommunications
media
Telecommunications
provider (e.g., telephone
company for Trunk Line)
Internet service provider
Other:
Power
Section 6 Optimize—Contingency Plan Assessment for EHR and HIE - 2
HVAC
Fire prevention &
suppression
Other:
Applications
Data (e.g., client
protected health
information, facility
budget, human resource
information/salary and
benefits data)
Other:
Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author.
Data Backup Plan
Record the following backup information, as applicable, for data, application software, operating
systems, and hardware (use additional rows as needed):
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Frequency may be continual, on schedule (specify schedule), or periodic.
Method may be full, incremental, or partial/differential (other terms may apply, such as
“image” for a server).
Media are the devices on which the backups are stored and may include a storage area
network, network attached storage, RAID, external disk drive, internal disk drive, or other
device.
File Naming refers to the versioning process to ensure effective and efficient retrieval.
Media Rotation refers to the process used to reuse media, if applicable.
Location refers to where the backups are stored (both temporarily and permanently).
Transport refers to how the backups get moved to their permanent storage locations (e.g.,
electronic transmission, bonded courier company, staff member private automobile).
SLA is presence of a service level agreement if backup is performed by and/or transported
and stored by a third party.
Recovery refers to the method by which the asset would be restored/replaced.
Testing refers to whether there is a routine or ad hoc testing schedule. Organizations may
wish to record testing dates and results.
Frequency
Method
Media
File
Naming
Media
Rotation
Data
Application
Software
Operating
Systems
Hardware
Section 6 Optimize—Contingency Plan Assessment for EHR and HIE - 3
Location Transport
SLA
Recovery
Testing
Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author.
Emergency Mode Operation and Disaster Recovery Plan
The following is an outline of the contents of an emergency mode operation/disaster recovery plan.
Use this to check the documentation and processes that exist in your organization and identify those
that are missing.
Plan Components
Introduction
Organization
Operations
Notification and Activation
Recovery Operations
Return to Normal
Operations
Appendices
Description
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Purpose
Applicability
Scope/Assumptions
Development
Maintenance
Testing
Record of Changes
References/Requirements
Steering Committee
Management Team
Support Teams
IT Resources Description and Architecture
Application Description and Architecture
Data Description and Architecture
Damage Assessment
Response
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Deployment of Teams
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Notification to Alternative Site
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Procurement of Resources
Dissemination of Public Information
Recovery Procedures
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Emergency Phase
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Backup Phase
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Recovery Phase
Concurrent Processing
Plan Deactivation
Personnel Contact List
Vendor Contact List
Notification List
Equipment and Specifications
Service Level Agreements or Memoranda of Understanding
Information Technology Standard Operating Procedures
Criticality Analysis
Related Plans
•
Related Contingency Plans for Patient Care
•
Emergency Management Plan
•
Occupant Evaluation Plan
•
Continuity of Operations Plan
Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author.
Section 6 Optimize—Contingency Plan Assessment for EHR and HIE - 4
Present?
Copyright © 2013
Section 6 Optimize—Contingency Plan Assessment for EHR and HIE - 5
Updated 11-20-13