When natural disaster strikes, few facilities are as critical as hospitals and health systems— it was just over one year ago when patient care organizations were searching for ways to quickly get back up and running after Hurricane Sandy ripped its way through most of the East Coast.
And perhaps just as important as hospitals are specialized treatment centers—such as cancer centers—in which patients depend on routine and planned care to help them with serious diseases. One of these such centers—the ProCure Proton Therapy Center, operator of three of the 12 proton therapy sites in the U.S., including one in Somerset, N.J.—faced a particularly unique challenge.
Through treatment centers in New Jersey, Oklahoma, and Seattle, proton therapy helps target cancer cells with higher doses of radiation while reducing exposure to healthy tissues. But while proton therapy is effective in fighting cancer, it’s equally dangerous to patients if the treatment is suddenly suspended or delivered improperly. As such, when Sandy struck, the stakes were high for ProCure. “Our situation is unique in comparison to other organizations in that we cannot treat our patients easily—there are only 11 of us in the country,” says Eric Winn, ProCure information systems director. “We can’t just hop over to nearest hospital and treat our patients.”
During the days leading up to Sandy when ProCure officials were monitoring the storm, it was decided that all of the systems would be shut down on the day before the storm hit, primarily because the organization was concerned about losing access to the center, mostly for internet connections, says Winn. “We do have generators that can last a couple days, but even so, we didn’t know if we could get people to the center to turn things off or get food delivered, or anything of that nature.”
That day, thanks to disaster recovery technology from the Hopkinton, Mass.-based vendor EMC, the treatment center identified a few critical patients that couldn’t miss a treatment, so they were treated instead on the Sunday before the storm hit the next day (ProCure normally doesn’t do weekend treatments).
“It was critical for us to get the images taken that day updated to their medical records and backed up and replicated offsite,” says Winn. “So after treatment on that Sunday, we initiated backups and replicated everything to our center and corporate office in Bloomington, Indiana. Then we initiated shutdown procedure, and the next day we lost power and internet. We weren’t aware of how long it would take to get back up, so we began contingency plans on how we would treat patients if we couldn’t get power back for the eight days or so that the government was projecting at the time.”
The first challenge, continues Winn, was figuring out how to identify those patients that need to be treated right away versus those who could wait a little longer. “Using the data we replicated back to Indiana, we restored it to a system there and provided remote access to the electronic medical record (EMR) for the clinical staff in N.J. so they could take go in and find out who needed to be treated and who could wait.” This data exchange was made easier due to all of the Procure centers operating under the same network, Winn says.
The staff was able to identify a few key patients who were a bit more critical than others, so those treatment plans were recovered and the data shipped to other centers around the country. The clinical staff in those centers reviewed those plans and figured out a way to treat the critical patients, says Winn. “On Wednesday, we were preparing a way to get those patients and fly them to other centers around the country for treatment. We were very fortunate, though, to get power back that afternoon.”
With the data replicated and restored, ProCure could now continue treatments with the correct patient data without interruption. But there were key lessons to take away from it all, says Winn, such as being able to anticipate the consequences of a storm with the size and scope of Sandy. “So you have a disaster, but what happens if you can’t get to the [treatment] center because of road closures? What if not only your internet is down, but everyone else’s is too? Having those backups available is important with an outage in such a large area. And getting access to EMR even earlier, before the storm comes is just as important. Anticipation of a large event is challenging, but everything should be done earlier.”
Of course, having a disaster recovery center offsite, such as ProCure’s in Indiana, will help. Because of this storm, some organizations have changed their disaster recovery plans, Winn says. “With some sites only 50-100 miles away [from the original center], both of their sites could have been affected, and that would be a nightmare. We were fortunate ours was 700 miles away.” People are also looking to the cloud for future disaster recovery backups, so no matter where disaster hits, they could be covered, he says. “With emerging cloud technologies and how cheap it is, it really makes a lot of sense to look in that direction.”
In terms of advice for patient care organizations, Winn does suggest that the disaster recovery site be tested or make sure the data works in the cloud well before any storm arrives. “You would like to think most places have that disaster recovery site, but it isn’t always the case. Some are operating in that traditional manner, and that’s scary, because you could end up losing a whole lot.”