Thursday was a terrible day. Our server went down at 2:30; then a transformer blew, and the electricity went out for my street at 3:30, for the rest of the day.
With no electricity, I could not even access my old charts, which are stored on my external hard drive. The data on those is already a couple of months old, but at least there is some information there. This is a risk of going fully paperless: if there is a major power interruption, I am stuck.
Having been through a couple of server problems earlier on, I had some idea of what to do: jot brief notes on paper; only give prescriptions that are not recurring (such as antibiotics), or recurring prescriptions for patients who were on only one medication and knew what it was (such as birth control pills). All complex renewals to be faxed to the pharmacy once the system was working again. It was difficult to function: people were asking me what the result of their tests were, and I could not tell them. None of my fancy recall systems were working: I had no flowsheets for a diabetic that came in; I could not remember exactly why I had asked an elderly patient with multiple problems and cognitive impairment to come in (and neither could he). I ended up rescheduling some appointments.
I work late on Thursdays; without access to the scheduler, we had no way to even call patients to ask them not to come if they were booked after sunset. My secretary brought some flashlights. One of my exam rooms has a window and faces West, so I saw patients there while there was still light.
The server came back on at 6:30 pm (which was of no use to me at the office, without electricity). I went home after seeing my last patient in the dark, and completed my charts remotely. I left for a conference the next day.
My group is very unhappy with this server interruption. We will be meeting with the company to discuss what happened: service interruptions can come from the hospital, from SSHA (which provides our internet access), and from the server itself. Since start-up, we have had interruptions caused by all three. Having a centrally managed server has advantages (managed backups, managed security, centralized upgrades, ability to securely share patient data between several providers), but also introduces complexity to the system. Along with this complexity come multiple possible failure points. I think my group is an early adopter of an enterprise-level system; down the line, it is probably the right way to go, but this week it just felt like a lot of birthing pains.