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Nearly all of us use and depend upon computers for running and operating our medical offices. I doubt there are many of us who could successfully operate our practices without these wonderful machines and this exciting, evolving technology which adds not only to improvement in the medical care we offer our patients but to the efficiency of our practices. When the computers malfunction an information technology (IT) person or the hardware manufacturer is contacted. But what happens when the computer crashes and all of the data is lost, i.e., our worst headache! For this article I have interviewed Renee Fowler, a computer guru, and the president of Selecting Computer Systems, Inc. , located in New Orleans, Louisiana. He has authored several chapters on this topic and writes a regular newsletter for physicians and medical practices on buying and maintaining computers and computer networks, as well as preserving and protecting computer data. He can be reached at 1.800.566.9644.

Mr. Fowler begins by defining a computer crash with three scenarios: You receive a call at home one morning and your employee tells you: you have a "disk crash," in other words, all of your files are inaccessible, or vandals have destroyed your computer, or a fire, a water leak or hurricane has destroyed your business. All of these instances are equal to the message "your computer and its data are not accessible."

The following list are some of the examples of disasters and accidents that can cause crashes and action steps you can take to prevent the loss of your irreplaceable data.

  1. Acts of God. Floods, heat, earthquakes, tornadoes, hurricanes. The solution is simple: back up your computers on a daily basis and store the tapes off site.
  2. Crime. Unauthorized changing of files, vandalism, sabotage, and theft. The solution is to store tapes off site and enforce password protection.
  3. Fire. The solution is not buying and storing your tapes in a fireproof safe as fires can reach such high temperatures and damage the magnetic data. The solution is, again, to store tapes off site.
  4. Magnetic fields. The solution is to keep back-up tapes away from video monitors, analog phones, etc.
  5. Operator error, accident, omission. The majority of lost data is due to operator error. Back up your system; rotate the backup. Most operator errors are due to carelessness. Although good training and documentation help, carelessness is difficult to plan for, therefore your best plan is to be able to retrieve your data prior to the carelessness.
  6. Power. Lightening, power failures, blackouts, power fluctuations, power surges. The solution is to purchase an Uninterruptible Power Source (UPS) for your server. A UPS system will keep your computer running for 30 minutes if there is an electrical outage. Mr. Fowler also advises that someone in the office check the UPS annually to assure it is working correctly. This can be accomplished by turning off your electricity and then see if your computer will continue to run or have the installer come out and test your UPS.
  7. Viruses. Can be introduced by a disgruntled employee, a competitor, or an accident. The solution is to keep the latest virus updates, such as Norton Utilities and McAfee VirusScan, at all times. Also, be extremely cautious when downloading from a network or the Internet.

According to Mr. Fowler there are a few basic steps for preparing an action plan should a crash occur. This begins with crash planning. Crash Planning is a written plan, perhaps in the employee manual or in your HIPAA plan, that incorporates strategies and procedures that will minimize damage in the event of a catastrophe that can potentially destroy your data. The objective of the plan is to return your business to an operational status quickly. The plan should incorporate:

  1. Names, phone numbers (home and business) of everyone involved, your key personnel, your hardware vendors, and your software vendors.
  2. Each step, the key person, in each department, should take if there is a computer disaster.
  3. An inventory of all hardware, software, and business forms such as your invoices, statements, paychecks, payable checks, etc. All individuals mentioned in the plan should have copies and keep one set off site in their homes.

Mr. Fowler suggests that there is no time like the present for developing your computer disaster plan and have it in place before a catastrophe occurs, as then it may be too late. After a disaster, everyone is functioning in a nervous, anxious, what do we do next mode. Everyone asking questions: Whom should we call? How do we reach them? What kind of computer equipment did we have? The result is that if you don't have a plan, plan on making many mistakes. Mr. Fowler advises that a crash plan is like insurance and none of us would think of practicing medicine without insurance. Wouldn't it be better, when receiving a call from one of your early morning employees, or fire department, telling you that a fire has burned down your office, to have some other course of action besides saying, "Wow," or perhaps something even stronger. Suppose instead you can open a drawer at your bedside table, pull out your crash plan manual, turn to the page of the steps you should take; then begin taking the appropriate action.

Let's look at a worse case scenario and that a crash occurs and you have not done any planning nor have you even backed up your system. Is there anything you can do? If a fire has destroyed your computer there is probably nothing you can do, however if you have enough computer left to dismantle, then call the people that you bought it from and ask if they can run your disk through a program and read the data. They may have to send it off to a specialist but in many instances, a repair specialist can read a crashed disk. If the vendor who sold you the disk can't do this work, look in the Yellow Pages under ComputersNetworking for a vendor whois certified to do warranty work on name brand computers. They will be able to help you, if in fact, there is any chance your disk is recoverable.

A computer crash can be every doctor's worst nightmare. I can promise you a more restful night's sleep if you t