Monday, January 25, 2010

Melissa Young, MD: The day the network went down

I don’t know why I didn’t immediately write about this on the day it happened. I must have blocked the painful memories, but somehow they resurfaced today.

It was an ordinary day. I saw patients in the office in the morning. Everything was running smoothly. I entered all my notes in the EMR. We had Internet. Nothing extraordinary.

I went to do rounds at the hospital at around 2 p.m. At 3 p.m., I get a text from my receptionist: “The computers are down.” Down? What does she mean “down?” They were fine an hour ago. And computers? Plural? Oh, no, no. This can’t be good.

So I texted her back (I do love texting): “Just the EMR or Internet, too?”
Good mother of all that is good and pure, what happened?!
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I ran back to the office. Sure enough, the computers were on, but none of them could connect to the network. Therefore, none of them had an Internet connection, none of them could run the EMR. And there in the waiting room was my next patient. I tried rebooting each computer. Nothing. I checked the server. That was on, had Internet, and could run the EMR. Now if I could see my patient in the computer closet that it was in, I would have been fine.

I called my IT company. They couldn’t “see” my computers. I was offline. Oh, sweet baby James, I was this close to having a stroke. OK, they said, unplug the switch, then plug it back in. Unplug the modem and plug it back in. I really hate that unplugging and replugging things just seems to be the way to fix things. Still nothing. My IT guy says he’ll send someone out immediately. Nothing could have been immediate enough for me at that point.

Meantime, I remember the patient in the waiting room. She fortunately had a good sense of humor and was rather amused at my agita. I took a step back. She’s a new patient, so it’s not like there was really anything in the EMR that I needed that second. I’ve seen patients for years without templates, and I’ve written notes on paper before. So, I forged ahead.

Funny, after only three months, it seemed almost foreign, but I went forth. And it was fine until I asked her if she had had recent labs. She said yes, and her doctor had faxed them to me. I slapped myself in the forehead. Of course, she had. But I couldn’t look at them, because all that would be in the EMR. She looked bemused again, “You don’t keep a hard copy?”

“We don’t get a hard copy. All faxes go directly into the computer.” So I go out to tell my staff to call the patient’s PCP to have them re-fax the labs, this time to our “old-fashioned” fax machine.

While they do this, I get a call from IT, “Turn off the server, then turn it back on.” Really, seriously? Fine. Now, a regular computer takes but a minute or two to reboot. “A server has a lot more going on” I’m told as I stand there impatiently. Then after what seemed like an eternity, it was back on. And, lo and behold! One by one the other computers on the network came alive. Hallelujah! We were back in business.

This happened about a week or two ago. It has not happened again. I have no explanation for what happened. Just the new-found wisdom that if it happens again to reboot the server. And a bill from IT for “minimum service – 2 hours” plus tax.

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