EMR data recovery can be challenging

Today, barely more than a quarter of physicians use electronic medical records (EMR) in an ambulatory setting, and roughly only 10 percent of hospitals have the technology to allow physicians to enter orders directly into a computer for transmission to the laboratory, pharmacy or other units. The consolidation inherent in a move to EMR has a number of implications, including the increased importance of IT infrastructure recovery capabilities.

Through the use of IT, patient records can be centralized to ensure that as records are updated, that information is reflected in a comprehensive EMR accessible to all providers. When records are decentralized a single event, such as a fire, flood or earthquake, are unlikely to destroy all those records. When records are consolidated in a single location, natural disasters and other downtime events are a concern.

Industry best practices dictate that up-to-date copies of any critical information repository, such as that represented by an EMR, should be regularly maintained at a secondary site far enough away from the primary site to ensure that a catastrophic event will not destroy data in both places. How up to date the recovery copy is becomes a critical issue. If a copy is created only once a day, then data loss on recovery is inevitable. For certain clinical-application environments, any data loss may put patient outcomes at risk. Potential drug interactions with newly prescribed medications are just one example where the lack of an ability to recover current, updated information may present a significant problem.

Newer data-protection technologies such as continuous data protection (CDP) and asynchronous replication over IP-based networks can help to address the more stringent recovery requirements driven by EMR implementations. CDP is a technology, similar in concept to TiVo, that continuously collects a stream of all the changes to a particular application in real time, including the most recent changes, and stores it in a log.

CDP changes the data-protection paradigm from the older “periodic” model, where backups are taken at predefined intervals, to one where there are no more discrete backups — data is protected and recoverable as soon as it is created. By spreading the capture of data changes throughout the day, CDP lowers the instantaneous resource requirements (CPU, memory, network bandwidth) of data protection operations, allowing even large and rapidly growing information repositories to be protected with negligible impacts on production operations.

If a recovery is required, CDP can instantly present a current, disk-based copy of the data, limiting data loss in almost any scenario to near zero. This technology also allows administrators to retroactively create a copy of what an application's data looked like at any previous point in time within a defined window, presenting the optimal recovery point even in cases where data corruption has caused a problem.

CDP is a technology that continuously collects a stream of all the changes to a particular application in real time, including the most recent changes, and stores it in a log.

CDP alone, however, is not enough when addressing site disasters. Asynchronous replication maintains a continuously updated copy of a production data set, such as a patient-record database at a secondary location. Because it operates asynchronously, distance is not a limitation. Unlike synchronous replication technologies, asynchronous replication can maintain a current copy of the data without imposing any performance impacts or degradation on production applications.

Newer implementations of asynchronous replication technology operate over cost-effective IP-based networks, and many can support replication between heterogeneous storage subsystems. Heterogeneous support can preserve investment protection in current storage, while it provides maximum freedom for new storage purchases. When used in conjunction with CDP, asynchronous replication can provide granular recovery at local and remote sites, enabling data recovery to the most recent data states at remote sites literally within minutes.

When using these technologies, the use of tape-based operations can be eliminated. Since disk-based data protection is more automated than tape-based approaches, administrative overhead and the risks associated with it are also lowered.

When making the decision to implement EMR, healthcare providers should be aware of the IT infrastructure impacts and modify their data protection approaches accordingly to provide rapid, reliable recovery and ensure that recovered data reflects the most up-to-date patient information.

Eric Burgener is the senior vice president of marketing for InMage.

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Published May, 2010