Section 6.10 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 more mission critical, clinical information systems are adopted.

Time needed: 16 hoursSuggested other tools: Section 1.4 EHR Technology 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 health information technologies (HIT) steering committee. The HIT steering committee needs to be involved in determining the criticality of IT resources, data, and applications. Some behavioral health facilities 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 facility 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 facility 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 the sections of this tool in sequence, reflecting the current situation at your behavioral health facility.

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, Acquisition Models for EHR and HIE), 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

Section 6 Optimize—Contingency Plan Assessment for EHR and HIE - 1

ownership and return on investment planning (see Section 2.11 Total Cost of Ownership and Return on Investment for EHR and HIE).

Criticality AnalysisUse 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 clients)o Critical (impacts productivity)o Important (manual workarounds suffice)o Deferrable (minimal impact)

For Data:o Private/Sensitive (disclosure adversely impacts clients)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 Level

Planned StateCriticality Level

Planned Remediation

IT Resources

Production server(s)

Test server(s)

Backup 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

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Other:

Power

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 PlanRecord the following backup information, as applicable, for data, application software, operating systems, and hardware (use additional rows as needed):

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

Location Transport SLA Recovery Testing

Data

Application Software

Operating Systems

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Hardware

Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author.

Emergency Mode Operation and Disaster Recovery PlanThe 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 Description Present?Introduction Purpose

Applicability Scope/Assumptions Development Maintenance Testing Record of Changes References/Requirements

Organization Steering Committee Management Team Support Teams

Operations IT Resources Description and Architecture Application Description and Architecture Data Description and Architecture

Notification and Activation Damage Assessment Response

• Deployment of Teams• Notification to Alternative Site• Procurement of Resources

Dissemination of Public Information

Recovery Operations Recovery Procedures• Emergency Phase• Backup Phase• Recovery Phase

Return to Normal Operations

Concurrent Processing Plan Deactivation

Appendices 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 Client 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 - 1

Copyright © 2014 Stratis Health. Updated 01-01-14

Section 6 Optimize—Contingency Plan Assessment for EHR and HIE - 1