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The causes of downtime

The most common contributing factors to downtime usually originate in infrastructure (e.g., networks or servers), software and OS upgrades or misconfigurations; glitching interdependencies between different software; or interface engine stability or changes.

For McFarland Clinic, one recent episode of downtime occurred when an HL7 interface went down and consequently caused the downstream PACS to stop receiving order messages. Luckily, McFarland had several downtime procedures and contingencies to deploy – and in this particular case, the clinic’s radiologists were able to switch over to a downtime worklist for studies that didn’t have matching orders yet. This enabled the radiologists to continue working while IT addressed the orders interface. The ability to pre-cache images on these worklists allowed the radiologists to continue reading studies as if nothing had happened.

Downtime is impossible to predict, but it’s also inevitable. You know it will happen eventually, just not when, so it’s important to be proactive both with monitoring and building downtime procedures. Because McFarland Clinic had preconfigured and mapped out contingencies to quickly pivot systems and workflows, it was able to ensure little to no disruption to patient care during a downtime experience.

The impacts & ripple effects of downtime

On hospitals and patients

When the PACS goes down, that has a massive impact on ED and ICU clinicians. Hospitals begin considering diversion and ambulances are forced to bring patients and trauma victims to other hospitals that are still online, but further away. This places major stresses on these other hospitals – which are bringing on many more patients than they are fit to handle – but also robs patients of the choice to go to the hospital of their choosing.

On clinicians

When systems go down, image backlogs skyrocket. Clinicians are then forced to work longer hours – nights, weekends – for weeks just to catch up. This has ripple effects on home lives and family schedules, too; you can’t be home in time for dinner or pick the kids up from practice if you are staying past 6pm every night catching up on week-old studies.

On the business

Downtime risks damaging a healthcare organization’s reputation and erodes trust – it erodes the trust of hospitals and clinicians in the organization, which trickles down to an erosion of trust from patients. A single organization’s radiologists may read images for multiple hospitals. When that organization’s PACS goes down, and providers and their patients withstand the worst of that downtime, it undermines trust in the radiologists’ ability to deliver a timely diagnosis.

McFarland’s experiences with downtime and Merge

For clinicians and IT, anxiety spikes when they experience downtime or see messages coming in from different sides of the business saying they’re down. Imaging solutions without a good security infrastructure baked in are more liable to be at risk for ransomware, malware, and other cyberattacks that threaten even greater downtime.

What gives McFarland Clinic confidence in their systems staying up is Merge’s proven track record in providing the proactive monitoring, maintenance, and architecture needed to ensure systems continually stay up with contingencies in place for when something happens.

McFarland has been working with Merge for over 10 years, with a lot of investment in understanding the ins and outs of solutions like Merge PACS, Merge Cardio, Merge Hemo, Merge Universal Viewer, and Merge VNA.

For all imaging organizations, the fears of downtime disrupting a clinician’s workday and their home life pervade no matter where they practice. Clinicians are already burned out as is; unpredictability around downtime, and the actual downtime itself, further fuels that.

But taking this anxiety off the plate, thanks to solutions with built-in reliability and business continuity, can ease these pains and provide imaging organizations with more controllable, resilient environments – and consequently, more confidence.

[getModule name="blockquote" quote="We work extremely well with Merge. We have confidence in the technology; replicating content management from the enterprise archive, with the PACS sitting on top and the virtual IP on the front end. If we ever do see issues with the PACS or our radiologists experience any slowdown, we can easily switch over to a Peer 2 PACS in a different data center within minutes, with minimal impact on the clinicians and support staff." author="Eric Lehmkul, Director, IT, McFarland Clinic"]