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● Tactical Operations


Planning for the unknown Maintaining your network infrastructure during a disaster. By Jason Free, Features Editor


D


ue to the critical nature of hospital care and patient information man- agement, every facility must create a plan of action for maintaining its


network infrastructure during times of crisis such as earthquakes, tornados or manmade disasters. I sat down with Rick Drass, Manager of Informa- tion Systems at Sarasota Memorial Health Care System in Sarasota, FL, to learn about the consid- erations he and his team make when preparing to face the unknowns that accompany times of crisis.


What are some of the fundamental considerations you make when formulating plans to sustain your hospital’s network infrastructure during a disaster?


T e fi rst thing we have to assume is that during any disaster we will lose everything. When that hap- pens, I have to ask, where is my backup and where is my backup-up location, my co-location (co-lo) facility? T is location is usually a bunker-based fa- cility that can withstand wind forces of a Category 5 hurricane. T is location should be somewhere that is not in the same general location of my facility. I need to make sure that at that location, all of our major systems are redundant. In other words, any critical systems that are operational within the hospital need to be duplicated at that co-lo facility. For example, our patient care information systems, you probably know them as health information systems, have to be fully backed up and running at our secondary location. So if the primary system is lost, the secondary system can immediately step in and pick up the work load. We also have to consider how we plan to maintain new informa-


tion. If the main hospital information system is lost, and we fi nd ourselves in a disaster situation like a hurricane, we still need the ability to triage new patients and to gather their pertinent information. So there has to be some kind of tagging and triage information system that is mobile and independent of the main hospital information system. T is back-up system must be operational here at the hospital and deployable into the fi eld at any given moment to handle any causalities in the area. In addition, the information that is gathered during the event must be able to be integrated back into the main information system once that system is restored.


What types of vendors are most helpful to you when you are preparing your disaster plans?


Initially, I would need to fi nd a vendor who had a leasable co-lo facil- ity that can withstand the eff ects of a disaster. Otherwise, a secure back-up location would have to be built from scratch. Next, we need to partner with our current major software ven-


dors. In our case, that would be Allscripts. T ey are our vendor of choice for our patient information system. We have to partner with them and make sure they have redundancy built into their system.


18 February 2014


Hurricane Charley threatens Florida in 2004 (Source: NOAA)


We also partner with companies like Microsoft to make sure that we can install a clustered environment that is fault tolerant. So, if one server goes down another server picks up the work load without a heartbeat being skipped, technically speaking. We also partner with local communication companies. T ese communication companies help us make sure that we have fi ber running from Point A to Point B and enough bandwidth to meet any contingency. (Point A being the hospital system and Point B being the co-lo facility.) We will sometimes partner with vendors who specialize in disaster


recovery drills or disaster recovery testing. T e idea is that once your system is in place, how do you know it is going to work unless it is tested? T e only way you know for sure is if you turn the switch off on “A” and let “B” take over. We run these kinds of drills on a regular basis.


Do you ever partner with companies who specialize in disaster recovery solutions?


Not generally. While we partner with a few companies who help us with subsets of our disaster recovery solution, we do not rely on an outside company for our enterprise solution. Most of the companies who specialize in disaster recovery will come on your site during a disaster and bring you servers and other equipment to get you back on line after the disaster has passed. However, we fi nd that those kinds of solutions are not useful for our needs. We need to keep the information technology systems running during an event. Many of the companies we have talked with seem to be fairly


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