Knowing what to do during an EHR outage helps clinic staff respond calmly, protect patient information, and keep care moving where it is safe to do so. The first priority is to understand what is unavailable, alert the right people, and follow the practice’s approved downtime procedures rather than improvising a workaround.
The sequence below uses the first few minutes, the next interval, and the remainder of the first half hour as an editorial aid. It is not a regulator-prescribed timeline. Adapt it to your specialty, staffing, EHR, and established policies. The American Academy of Family Physicians’ downtime preparation guidance and the federal SAFER Guide on contingency planning can help practices develop and review their own plans.
First few minutes: Check safety and confirm the scope
Start with patient care. If a patient needs urgent attention, follow your clinical escalation procedures. Do not let troubleshooting delay care. Clinical staff should make care decisions using their training, available information, and practice policy.
Next, establish whether the problem affects one workstation or a wider service. A single login issue, a network connection problem, and an unavailable EHR may look similar to the person who first reports them, but they call for different responses. Ask whether colleagues can access the system and whether specific functions, such as e-prescribing, laboratory interfaces, or the patient portal, are affected.
- Note the time the issue began and what staff can and cannot access.
- Record any error message or recent change that may help support staff identify the problem.
- Use the organization’s designated support channel to report the issue.
- Avoid sending patient information through personal email, text, or another unapproved channel.
Do not assume that a partial outage means the entire EHR is down. If one function remains available, staff should use it only as permitted by the practice’s procedures. The designated leader, incident coordinator, or other authorized person should determine whether to declare downtime and activate the relevant workflow. Staff should not make separate, conflicting announcements.
Next: Assign a coordinator and activate approved procedures
Once the issue is reported, make sure someone is coordinating the response. In a small clinic, this may be a designated staff member who also has other duties. The coordinator can keep a shared picture of the outage, relay updates through approved channels, and make sure unresolved work has an owner.
Tell staff which services are affected and where to find approved downtime forms and instructions. Use the forms and communication channels prepared by the practice. If staff cannot locate them, the coordinator should follow the organization’s escalation process instead of creating an informal substitute that could omit important details.
For each patient encounter, use the identity checks and approved sources of clinical information in your downtime procedure. Confirm identity as your practice requires. If allergy, medication, or history information is unavailable or uncertain, do not guess or treat missing information as confirmation that no concern exists. Follow clinical escalation procedures and clearly note what could not be verified.
Paper documentation should be legible and complete enough to support continuity and later reconciliation. Depending on your approved forms and workflow, record relevant encounter details such as:
- Patient identification using the practice’s approved process.
- Encounter date and time, clinician, and relevant clinical observations.
- Medication decisions, prescriptions, orders, referrals, and follow-up instructions.
- Information that could not be checked, along with any action taken to resolve it.
- Tasks still pending, the person responsible, and the next expected action.
Keep paper records protected from casual viewing and access. Follow the clinic’s procedures for storing, moving, and securing downtime documents. The EHR Downtime Task Force patient safety guidance is another resource for planning how to manage care and documentation when the system is unavailable.
During the first half hour: Manage patients and unfinished work
Have the coordinator or assigned staff member maintain a practical view of the waiting-room queue and the services that remain available. Share clear, respectful updates with patients without disclosing another patient’s information. If the disruption affects appointment timing or a service the clinic cannot safely provide, follow the practice’s process for delays, rescheduling, or escalation.
Whether the clinic continues seeing patients depends on the circumstances, clinical judgment, staffing, access to necessary information, and the practice’s approved downtime plan. There is no one-size-fits-all answer. The appropriate clinical and operational leaders should decide what services can continue and communicate that decision to staff.
For orders, prescriptions, referrals, and results, use the clinic’s specific downtime workflow. Make sure each item is documented and assigned to a responsible person. Pay particular attention to work that could otherwise be lost in the transition, such as an order that has been prepared but not sent, a result that arrives during the outage, or a prescription that needs follow-up. For more on maintaining responsibility for results, see this guide to lab results follow-up workflows.
Keep a running list of open tasks and any changes to the outage’s scope. If the issue shifts from one unavailable feature to broader EHR or network disruption, alert the coordinator and follow the designated escalation process. Avoid relying on memory or informal handoffs, especially when work passes between staff members.
When the EHR returns: Reconcile before closing the loop
Restored access does not automatically mean every task is complete. Follow the practice’s approved recovery and reconciliation process. Confirm with the designated coordinator or support contact that staff should resume normal workflows, and clarify which system functions are available.
Then account for downtime documentation and open work. Enter or reconcile information in the EHR according to clinic policy, and make sure each paper encounter, order, prescription, referral, and result has an identified status. Check for duplicate work before repeating an action that may already have been completed through another approved process.
Keep paper records secure while reconciliation is underway. Handle or retain them according to the practice’s record-management procedures, rather than discarding them simply because the EHR is available again. The clinic’s disaster recovery planning should address how staff move from downtime back to routine operations.
Frequently asked questions
How should clinic staff confirm that an EHR is down?
Check whether the problem affects one workstation, multiple users, the network, or particular EHR functions. Report what you observe through the designated support channel. Let the authorized person decide whether the downtime process should be activated.
Who should declare or coordinate an EHR downtime?
The person designated in the organization’s downtime plan should coordinate the response and follow the approved declaration process. Staff should report issues promptly and avoid making conflicting declarations.
Should a clinic continue seeing patients during an EHR outage?
That depends on patient needs, available information, affected services, staffing, and clinic policy. The appropriate clinical and operational leaders should decide which services can continue safely and communicate the plan to staff.
What should staff do with paper records after the EHR is restored?
Use the clinic’s approved reconciliation process to enter or otherwise account for the documentation and close out pending tasks. Keep paper records secure and handle them according to the organization’s record-management procedures.
Prepare before the next interruption
A usable downtime plan gives staff clear roles, approved forms, secure communication options, and a way to track unfinished work through recovery. Zevonix serves healthcare providers in Palm Coast and Flagler County, with a focus on healthcare IT, EHR support, and cybersecurity. To discuss your clinic’s downtime readiness, call (386) 260-0777.