Ensuring Continuous Operation: The Critical Role of Redundancy in Healthcare Information Systems
In the ever-evolving healthcare landscape, the need for resilient and reliable information systems has never been more pressing. At the heart of this reliability is redundancy, a practice that serves as a safeguard against unexpected failures and disruptions. Redundancy involves the provision of duplicate, backup equipment, processes, pathways, or systems that immediately take over the function of failed components to ensure uninterrupted operation. For healthcare organizations, implementing redundancy is not just a technical strategy—it's a critical failsafe for maintaining patient care and operational efficiency.
The Importance of Redundancy in Healthcare
Information systems are the backbone of today’s healthcare industry, encompassing everything from electronic health records (EHRs) to ePrescribing networks. These systems facilitate the seamless flow of critical information among healthcare providers, pharmacies, patients, payers, and PBMs. However, they are also susceptible to various disruptions, whether from technical failures, cyber incidents, or human errors. Redundancy ensures that even in the face of such challenges, these systems can continue functioning without significant interruption.
Cyber Incidents Highlight the Danger of Single Threaded Systems
The critical importance of redundancy is underscored by recent cyber incidents that reveal vulnerabilities in healthcare systems. In February 2024, Change Healthcare experienced a significant ransomware attack, highlighting the need for robust redundancy measures. With an alleged 4 TB of patient data compromised, the attack demonstrated how vital it is to have comprehensive backup systems in place. Redundancy ensures that healthcare operations can continue smoothly, even when primary data and processes are held hostage, by allowing systems to switch seamlessly to backup data and infrastructure. This capability not only maintains operational continuity but also facilitates rapid recovery and minimizes disruption to patient care, underscoring the necessity of redundancy in safeguarding healthcare services.
In July 2024, a flawed software update from CrowdStrike resulted in widespread system failures, affecting hospitals' ability to perform surgeries and access patient records. This incident disrupted healthcare services and highlighted the vulnerability of systems without robust redundancy measures. These examples demonstrate the potential for catastrophic outcomes when redundancy is not adequately integrated into healthcare information systems.
Redundancy in Action: Real-World Solutions
A real-world example demonstrates the effectiveness of redundancy in healthcare. Guy's and St Thomas' Hospital employs data and storage redundancy solutions, such as those provided by Azure Cloud, to maintain continuous operation during system failures. By using backup systems located in different geographical locations, the hospital ensures that if the primary IT infrastructure fails, the backup can take over with minimal downtime. Similarly, pharmacy service provider, Giant Eagle, was able to switch to a different billing mechanism to continue delivering uninterrupted patient care.1 These setups allow for uninterrupted access to critical patient information, even during unforeseen events such as power outages or server malfunctions.
1 Pharmacy information company hack has impact on Western Pa. pharmacies, chains
FDB Vela: A Reliable Player to Help Address ePrescribing Redundancy
A redundant ePrescribing network is essential to avoiding unwanted health outcomes. Over the last two decades, the US healthcare industry has achieved nearly universal adoption of ePrescribing. However, until the 2022 launch of FDB Vela, a cloud-native ePrescribing network, ePrescribing network options were limited, with one ePrescribing network dominating the market. This singularity poses significant risks during service interruptions.
Bob Katter, FDB President, stated, "Having more than one network provides important benefits to the nation’s healthcare system in terms of greater availability and reliability, as we unfortunately have recent examples of the costs to the system of not having such redundancy. Furthermore, competition in the ePrescribing marketplace will drive greater innovation and economic efficiencies, both of which are sorely lacking in today’s system dominated by a single network. For these reasons, stakeholders across the healthcare industry have expressed to us the need for a choice of networks. FDB Vela meets this demand and reduces the barriers to participation with easy onboarding and advanced functionalities, all supported by a highly scalable, fully redundant platform built on Microsoft Azure technology”
Lathe Bigler, General Manager at FDB Vela, describes their "security-first architecture" as a foundational element in achieving HITRUST certification rapidly.
“We built FDB Vela using rigorous protocols and design elements that HITRUST and other cybersecurity authorities evaluate during their certification processes,” said Bigler. “By starting with a security-first mindset and leveraging the latest secure technologies in our design, FDB Vela earned HITRUST Risk-based, 2-year (r2) Certification in only six months, which is a remarkable achievement.”
FDB Vela also includes API integration enabling electronic health record (EHR) developers to readily tap into features such as real-time pharmacy benefit services and electronic routing for specialty drugs to create services, customize e-prescribing workflows and streamline processes. FDB Vela also supports all e-prescribing standards set by the National Council for Prescription Drug Programs (NCPDP) and other pharmacy organizations.
Prioritizing security at every level demonstrates FDB Vela’s commitment to protecting patients and network participants now and going forward with diligently maintained and proactively improved controls well ahead of cybersecurity risks
Looking Ahead: Building Resilient Healthcare Systems
As healthcare organizations continue to digitize and integrate more advanced technologies, the role of redundancy will only grow in importance. Executives and IT leaders must prioritize the integration of redundant systems within their infrastructure, not only to protect against potential failures but to ensure the continuous delivery of quality care. By investing in redundancy, healthcare organizations can build a foundation of resilience, ensuring they are prepared to face any challenge without compromising their commitment to patient care.
Redundancy in healthcare information systems is a critical safeguard that ensures operational continuity and protects patient care. By embracing redundancy, healthcare organizations can enhance their resilience, minimize service interruptions, and maintain the high standards of care that patients deserve.
Here's a bibliography for the additional sources:
- National Institutes of Health (NIH). "Redundancy in Electronic Health Record Corpora." Available at: NIH.gov.
- Chief Healthcare Executive. "The Multibillion Dollar Consequences of Fragmented Healthcare Information Systems." Available at: ChiefHealthcareExecutive.com.
- National Institutes of Health (NIH). "Interoperability of Heterogeneous Health Information Systems." Available at: NIH.gov.
- "The Power of Resilient and Redundant Healthcare Systems." UHIN Blog. Accessed September 11, 2024. https://uhin.org/blog/resilient-redundant-systems/.
- "Considering Data Redundancy Solutions for a Hospital During a Crisis." LinkedIn Pulse. Accessed September 11, 2024. https://www.linkedin.com/pulse/considering-data-redundancy-solutions-hospital-during-marsha/.
- "Case Studies in the Failure of Healthcare Information Systems." University of Glasgow. Accessed September 11, 2024. https://www.dcs.gla.ac.uk/~johnson/papers/AHRQ/case_study.pdf
