W00_24f: DOWNTIME - RESPONSE TIME - DATA SECURITY - ENCRYPTION

DOWNTIME:
Downtown period is aggravating. There are studies that show that the IT professionals don’t understand that the impact of 1 minute of downtime during the middle of the day percolates through the system throughout the day. In one example, a system went down for a minute, and the alert system did not work so the wrong medicine was given to the patient. This is important because no system has been created that does not go down. We have all kinds of solutions: buffers, redundancy, go to another server; but even with those safeguards, systems still go down. Also remember when you become totally electronic, suddenly you don’t have paper.

RESPONSE TIME:
When you hit the click button, the response time that physicians want are seconds. This problem is accentuated in remote locations where you don’t have broadband and you are still using telephone lines. In some rural counties, they had to install T1 lines at a huge cost, which, by the way, could also use the funding money. CT got 90 million dollars for broadband (don’t know why because the northeast corner is the only area not connected.). Just think what California got, with all its rural counties. Research shows that CPOE systems take 6 more minutes than by issuing orders by hand, and one of the main causes for this is low response time.

DATA SECURITY:
The cost of securing your data could be bigger than the cost of implementation. However, advances in technology are creating cheaper protection. There is a way to lay out your network for it to be secured, that’s why security is cheaper if it is included from the beginning, in your plans of network design. It is very important that infrastructures in which you put the electronic health record be secure. Although nothing is 100% secure, mainly because of human folly. The administrator goes on a one-week vacation and he writes the ID’s for the servers so they can be updated. That is a breach of security.

ENCRYPTION:
Sharing of information is protected by the TPO clause in HIPAA. To be able to run a healthcare organization, information must be shared. They use the encryption process to protect that data. Encrypted data over the lines means that only the ones who have the key are able to decode the data. The claims data that is paid both in Medicare and Medicaid also uses this encryption software. Both physical security and technical security is implemented. But even with encryption, data still can be compromised, for example by losing a laptop or with a disgruntled employee. You can’t turn humans on and off. You can increase the threshold but you cannot eliminate the risk. But on the other hand, if the information is so difficult to access it (because of so much encryption) then it loses all its value. It is a balancing act.