Comments
Practice Fusion EHR Caught In Internet Brown-Out
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David F. Carr
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David F. Carr,
User Rank: Author
8/15/2014 | 10:40:40 AM
Cloud versus closet
For the small medical practice like Practice Fusion, the real question is whether a cloud based EHR would be more reliable than one in the server closet down the hall, with staff or a contractor to maintain it. In many cases, the answer is probably yes.

Of course, manilla folders rarely suffer brownouts.
Laurianne
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Laurianne,
User Rank: Author
8/15/2014 | 1:34:53 PM
Re: Cloud versus closet
Customer support will make or break how cloud-based providers of many kinds weather outages. Customers may forgive vendors when service goes out, but they expect clear communication during the outage.
Alison_Diana
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Alison_Diana,
User Rank: Author
8/15/2014 | 2:24:17 PM
Re: Cloud versus closet
Looking at Practice Fusion's social media posts during the outage, the company updated pretty frequently and provided links to educate users on what they said was the underlying cause of the brown-out. Of course, when lots of people flood support phone lines, many companies cannot keep up with the unexpected surge in usage (which is something several online commenters said was the case at Practice Fusion). Not sure whether PF used some kind of automated message to let users know they were working on the problem, but that's one first line of support and communication in these cases.
Alison_Diana
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Alison_Diana,
User Rank: Author
8/15/2014 | 2:25:29 PM
Cloud Beats Alternative
Reached after deadline, office manager Kayla Winter told me: "Fortunately, we did not have clinic on Wednesday and that was the only day I was down. I did send the staff home because there was no use in them sitting on the clock. Yes, we do plan on staying with PF barring this is not a regular occurrence. I'm sure you know it's quite an undertaking trying to move data from one EHR to another and this hopefully was an isolated incident. We have been on a non cloud based system and had way more trouble so no, this will not deter me from cloud based systems."

 
moarsauce123
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moarsauce123,
User Rank: Ninja
8/16/2014 | 10:07:11 AM
Re: Cloud Beats Alternative
No matter if cloud or non-cloud, everyone relying on systems needs to have a "plan B". It always annoys me to no extent when my bank refuses to give me my money because "the computers are down". Seriously? That is when you take the ledger out and account by hand. This is how the Fugger family started and banks after them operated for centuries. Why have anyone sit at the counter when they aren't even capable of the most basic form of banking?

In health care a valid reason to not see patients is that there are no doctors available, either because there is no doctor there or they are swamped. If a computer system is that essential then you need to have at least one backup plan ready at all times. Write down the patient's information, make a copy of their insurance card, and then tell them the doctor will see you shortly. Once the system is available again type the records in. That not only helps the people coming in, it will also get the place paid.

Have we come that far that computers rule everything causing folks to lose focus from what really matters?
Alison_Diana
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Alison_Diana,
User Rank: Author
8/18/2014 | 11:49:55 AM
Re: Cloud Beats Alternative
You bring up a lot of great points. I can only imagine how patients felt -- perhaps after waiting for weeks or months for an appointment, perhaps running out of critical medications or feeling awful -- when appointments were canceled on the same day as service. The idea of a paper or local backup makes a ton of sense. It does seem that Practice Fusion (and no doubt other cloud EMR developers) either currently or will soon allow providers to access their data offline. By saving that data in a couple of locations, providers should be able to access information even if their network or their EMR provider's network goes down. Regarding keeping paper records, that might be too onerous, given the manhours and money required to maintain both paper and electronic. 

Would love to hear from any practices that take this belt and suspenders approach and whether it's come in handy during a network outage (of any cause)?
Alison_Diana
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Alison_Diana,
User Rank: Author
8/19/2014 | 9:57:58 AM
Additional Statement from Practice Fusion
"Last week, Practice Fusion's platform was never down but its third party data center provider, QTS, experienced 512K issues with their primary and secondary networking equipment" - according to the same company spokeswoman.

Me again: The cause of the brown-out seems to have been the 512K issues, but I think most people say a site is down when they can't access it, whether that's strictly accurate or not. 


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