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1 Preventing Data Loss INSIDE > Disaster Recovery Types and Categories > Disaster Recovery Site Types > Disaster Recovery Procedure Lists > Business Continuity Plan 1

2 Preventing Data Loss White Paper Overview In today s health information technology environment, providers have access to various tools and applications that can make the provision of care a streamlined process. While full adoption of electronic health records has not yet been achieved, adoption rates continue to rise with each passing year. The addition of advanced information technology to healthcare brings with it the necessity to prepare and prevent the prospect of data loss. The prevention of data loss can be achieved by proactively creating plans for disaster recovery and business continuity. The following document outlines the steps HealthMEDX has taken to prevent data loss and to properly arm clients with the necessary prevention best practices. Disaster Recovery Types and Categories The purpose of any disaster recovery plan is to provide a detailed plan of action to address and recover from the complete or partial loss of facilities, hardware, software, or access to any application, service, or other technical solution. The disaster recovery plan outlines how to restore a system to an operational state after a disaster. Proper disaster recovery plans address a number of categories and disaster types. Each of which should be addressed within the plan to mitigate the potential loss of data at every level. These various categories and types should address a variety of technical concerns, including: Hardware recovery and replacement requirements Software recovery and replacement requirements Physical network and infrastructure requirements Operating system and Windows Active Directory and Domain replacement Specific project plans and checklists Appropriate disaster categories are typically based on the tolerance for the type and amount of data that could lost under different scenarios. For all systems, both complete and partial loss categories should be addressed. A complete loss is categorized by the total loss of services or access to data within the system. A partial loss is categorized by the partial loss of data access or services within the system. 2

3 There are seven key disasters types that should be addressed within each disaster category. They are: Fire Flood Earthquake Loss of power resulting in a system operating at less than full capacity Personnel disaster resulting in hardware or software not being available due to the lack of human interaction Hardware disaster resulting in a failure of the equipment used in storing, processing and transmitting data The final disaster type is a connectivity disaster which holds unique planning needs. Partial loss of Internet connectivity, private T1 connections, and similar connections, can be moved to the Internet temporally thus alleviating the need for a partial connectivity loss plan. Disaster Recovery Site Types In planning for disaster recovery, the setup of alternate sites for redundant data storage and access are also recommended. There are three types of recovery sites providers should establish to be fully prepared for disaster recovery. The first, and most important, recovery site type is a cold site. Cold sites provide an alternate contracted site or location with the electrical and communication infrastructure available to bring systems online with very little notice. Equipment and software are installed and configured at this facility in the event a disaster is declared that prevents the use of any other site or solution. The cold site can be thought of as the location and solution of last resort and may take days or even a week to be brought completely online. A warm site is a recovery site that provides an alternative physical location that is generally far enough away from the production site that it might not be affected by the same issues that might affect the production site, like storms, earthquakes, or other natural disasters. The warm site typically has a full or partial infrastructure that is configured with a recent copy of an organization s production data and applications. In the event of a disaster the warm site can be brought online with minimal effort and in a reasonable time frame allowing access to systems in about a day or two. A hot site is a recovery or mirror site that provides an alternative physical location that is far enough away from the production site that it generally should not be affected by the same issues that might affect the production site, like storms, earthquakes, or other natural disasters. The hot site typically has a fully operational infrastructure and in some cases even contains a complete copy of the production infrastructure that is configured and online with a near real time copy of an organizations production data and applications. In the event of a disaster the hot site can be brought online with little to no effort, sometimes within minutes of the original disaster, thereby allowing immediate access to all systems and supports complete business continuity. 3

4 Disaster Recovery Procedure Lists Identifying the possibility of a Disaster Recovery (DR) scenario is the initial step for any disaster recovery procedure and generally begins with an initial call or alert being sent to the on-call IT team member. Once the call or alert is received, the on call IT team member should attempt to resolve the issue through the outlined support methods. If the issue cannot be resolved through normal support methods, the on call IT team member should follow a provided disaster procedures list. The procedure list should cover the steps that need to be taken to recover and the internal and external communications that should occur, including but not limited to management, users, and software/service providers. Business Continuity Plan The purpose of a Business Continuity Plan is to have a logical plan detailing how an organization will recover from complete or partially interrupted services. In other words, it s a roadmap outlining how the organization will plan to stay in business and continue to provide services in the event of a disaster. In determining business continuity plans, it is always recommended to speak with software providers to determine what pre-planned paths are available from the vendor to provide continuity. The establishment of cold, warm, and hot disaster recovery sites is a critical step in this process. The following outlines the disaster recovery services HealthMEDX provides clients to address business continuity planning. HealthMEDX Cold Site Solution Available to both Hosted and Self-Host clients, the HealthMEDX cold site solution is available by simply following best practices for backup and recovery. This backup and recovery process includes performing application and Virtual Directory backups and restores. SQL Server databases and restores as well as any other backups are also performed as part of this process. The cold site solution requires the client or HealthMEDX Data Center to perform nightly full backups. Transaction log backups are also recommended. Backups of the entire application and database are also taken and stored offsite and/or in redundant storage. In disaster recovery scenarios, servers, network, and storage are installed from the cold site. Data is restored to a new environment with modifications to the application and configuration. User access is also restored from the cold site. 4

5 HealthMEDX Warm Site Solution The HealthMEDX warm site solution is available to both Hosted and Self-Host customers. The warm site solution is available through the utilization of Advanced Clinical from HealthMEDX. Specifically, the warm site solution is provided through orders and emar/etar functionality. Facility or campus level disaster recovery workstations should be installed with a user access process established by the client. A connection to a backup generator or power source as well as a printer is required for the warm site solution. Often times, this is achieved with a simple laptop device with printer access. Within the warm site solution, scheduler jobs are created for orders in HealthMEDX Vision. These jobs are run at regular intervals. A script is also run on the application and disaster recovery PC to export data to facility or campus disaster recovery workstations. In a disaster recovery scenario, appropriate users connect to assigned disaster recovery workstations to view or print orders on demand. The cold site solution might also be invoked. While operating from the warm site solution, notes are recorded manually to be entered into the system after user access is restored. HealthMEDX Hot Site Solution Available to both Hosted and Self-Host customers, the HealthMEDX hot site solution is a custom solution provided by HealthMEDX IT. In the hot site solution, disaster recovery agents are installed on HealthMEDX Vision servers in the primary or product data center. A secondary or backup data center exists with servers, network, and storage online. Disaster recovery agents are also installed on these secondary or backup servers. Outside of the disaster recovery agents, replication sets are established to include and mirror the entire application and database from the primary site to the secondary or backup site. In a disaster recovery scenario, use of the hot site is approved and user access is switched to the hot site. User access is restored for full production use on the secondary or backup servers. 5

6 HealthMEDX Disaster Recovery Tool HealthMEDX has developed a tool for all clients to use in the event of a disaster that provides an electronic copy of the Face sheet, Medication, and Treatment Orders on a facility by facility or wing by wing basis. This tool can be used to accommodate access to data for both planned and unplanned outages. The tool provides Copy of MAR/TAR/OAR Copy of Face sheet This solution provides clinical staff with the ability to immediately print and work with key clinical information in the event of an outage. HealthMEDX Best Practices For clients to utilize a complete disaster recovery plan with HealthMEDX, the following outlines established best practices to be followed by HealthMEDX clients. Establish nightly full backups for cold sites Establish nightly transaction log backups for cold sites Establish nightly application and database backups in redundant storage Utilize HealthMEDX Vision Advanced Clinicals to establish a warm backup site Install facility or campus level disaster recovery workstations with the following minimum specifications: - Minimum 2.0 GHz 32-bit (x86) or 64-bit (x64) processor Multi-Core processors are highly recommended - Minimum 17 Display with 1280x1024 resolution cable of displaying 32-bit or higher color schemes GB or more reserved disk space to store DR content and cached reports GB of RAM or more 4.0 GB of RAM or more is highly recommended Work with HealthMEDX IT to establish a custom hot site Fax N. Towne Centre Drive Ozark, MO

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