Don't forget IT factors in disaster planning

Address loss of power, server, communications

Your disaster plan is complete. You know who is responsible for every aspect of contacting patients, contacting employees, arranging transportation, documenting evacuation plans, providing medications and supplies during the emergency, and keeping track of patient records. You are ready for weather-related emergencies, power outages, and transportation difficulties.

What about your information technology (IT) systems? Have you made all the plans you should?

The IT system disaster plan is one of the most difficult to develop and implement because it involves so many different departments with so many different needs, admits Rajesh Shetye, MS, MBA, executive vice president of information services for VNA Healthcare Partners of Ohio in Cleveland.

"Because it involves all departments, it is important that the support for creation of a disaster recovery plan for IT systems comes from top administrators," he says. "The key to a successful IT recovery plan is to pull resources from all areas of the home care agency, not just the IT staff," he adds.

Your IT recovery plan should be detailed and consider all aspects of potential disasters, including who will be available to implement the plan," Shetye explains.

"This means spelling everything out clearly and making no assumptions." Once the plan is written, don't forget to test it, he adds.

What problems could your agency face?

There is no such thing as a standard disaster plan that can apply to all agencies, Shetye says. "In Cleveland, the threat of damage from hurricanes or tornadoes is not realistic, but we can face power outages in the winter," he explains. "Prioritize the most likely threats and develop your plan to address them."

Include potential disasters such as your building becoming unavailable due to fire or weather damage, a single phone line available rather than multiple lines, damage from fire or water, or a telephone switch that is not working due to cable problems, suggests Shetye.

In addition to her location in a hurricane-prone area, Debbie Sweade, office manager for Omni Home Health in Homosassa Springs, FL, points out that most of Florida also is in a flood zone.

"Our plan not only covers protection of the data, but also protection of the hardware," she explains. Whenever there is a possibility of a storm that might cause flooding, they disconnect and move all hard drives onto high shelves, adds Sweade.

"We have had times when we've gone through this exercise every day for several days in a row," she adds. "While it is time-consuming to put everything up and then take it down and reconnect the next morning, it is better to be safe than sorry and lose all of your equipment."

Know who uses your system

Once you've identified the most likely problems you'll encounter, develop a plan to address them, Shetye recommends.

"If you lose a server during a power outage, you will need to recover the information on that server," he says. "Make sure you have an inventory of what users are on that server, what information is stored on the server, and what impact the loss of that server for a period of time will have on the agency."

Obviously, servers that contain patient information are critical, and your plan for restoring that information should address the problem as soon as possible, Shetye adds.

For power outages, you might consider adding generators that will keep servers running, he suggests. If you are concerned about servers that quit working, find out which components are most likely to fail and take steps to have those components in-house or know how to get them quickly, Shetye notes.

"Make sure you make backups on a regular basis and consider storing critical information in two different places simultaneously," he adds.

Also, make sure you back up information from laptops and desktop computers frequently, Shetye continues.

"If a nurse uses a laptop during the day, he or she should transmit that information to the server at least once each day. If the patient load is heavier on some days, the information should be sent twice during the day," he recommends.

To reduce the chance that you will lose all of your telephone lines at once, you might look at using different lines from different carriers that enter the building at different locations, says Shetye.

"This is easy for a larger agency, or an agency located in a larger city with a variety of different carriers," he says. "Smaller agencies or agencies in more rural areas may not have this option."

Another option also might be setting up Internet connectivity, Shetye suggests.

"This allows your users to access your server through any Internet service provider from a remote location," he points out.

Omni Home Health opted to use a company that is located away from their location to house and maintain their servers, Sweade explains.

"The company is responsible for testing recovery plans and backing up our information on a daily basis to ensure that we don't lose information," she says.

"We do require our nurses to transmit information at least once each day so that the most information that can be lost due to a disaster is one day," Sweade adds.

Consider laptop's potential uses

While his agency doesn't use wireless transmissions for communications or information transmission, Shetye does say that option is a viable one to consider.

"A laptop transmitting through a high-speed cell phone is just as effective as using a land line to transmit information," he says.

Agency managers need to evaluate wireless coverage in their markets to ensure that nurses will get a signal in all areas they visit before committing to wireless, Shetye suggests.

Don't forget some paper backup, recommends Sweade. "We do keep paper backups of patient information, but we store it at a different location," she says.

A paper backup of the schedule, list of patients, and contact information for patients and employees should be printed once each week, notes Shetye.

"If your system is only down for two to three days, paper backups can help you make sure you don't miss visits or contacts with patients," he adds.