“If one of those computers gets affected, suddenly all your disinfection processes have to slow down or even stop, and then all operations have to stop,” he said.
With large health care systems employing thousands of employees and caring for large numbers of patients—last year, Michigan Medicine over 2.7 million Outpatient visits—Modern health care has become essential thanks to digitization, from systems that relay communications between busy departments to electronic medical records, or EMRs, that store vital information about each patient.
But in recent years, troubling reports have emerged about the potential consequences of such systems breaking down. Studies have shown that during electronic health records outages, lab test results are delayed due to average 62% compared to normal operations, whereas in the NHS, IT failures are directly linked to cases of patient harm.
In April, Sofia Mettler, then a resident physician at Mount Auburn Hospital, announced a piece of paper in JAMA Internal Medicine, where she describes a day when the hospital’s EMR system was down for seven to eight hours. The disruption meant that morning blood samples could not be collected because the phlebotomy team did not know which patients needed which tests, while test results taken before the outage could not be disseminated, making it more difficult to assess overnight progress.
That experience paled in comparison to the consequences of the CloudStrike outage, said Mettler, now a pulmonary and critical care fellow at Brigham and Women’s Hospital.
“This time, the outage was much more severe,” she said. “We can’t use any software that relies on digital transmission. For example, we can’t review CT scans because the radiology software is down. It’s hard to make clinical decisions without access to something that has become an essential part of medicine. We’re using ultrasound at the bedside, but it’s not as good as a CT scan at telling us what’s going on in the lungs.”
In the event of such incidents, hospitals are supposed to have paper-based backup systems and ensure that critical equipment such as IV pumps, blood pressure monitors, and ventilators are controlled on internal networks that are isolated from the internet, said Dean Sittig, a professor of bioinformatics at the University of Texas Health Science Center at Houston. But that doesn’t always happen. “Every hospital has fire drills, but they should also have things like downtime drills, where they shut down computers and make sure everything is still working,” he said.
There are many reasons why computer errors can lead to patient safety issues, such as delays in prescribing certain medications, Sittig said. But some of the biggest problems are more subtle, such as staffing shortages. In a health care facility that relies on hand-delivered lab test results, there can be delays in discharging patients, which means they stay longer and are more susceptible to infection.
