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Lessons for Healthcare From the Global IT Outage

— A robust and resilient infrastructure can help ensure continued access to care

MedpageToday
A photo of a man holding a smartphone displaying the CrowdStrike website.
Moura is a clinical neurologist and a health informatics expert.

The recent global information technology (IT) outage, which spurred thousands of flight cancellations and significant disruptions in banking, healthcare, and retail, has starkly underscored the world's growing dependence on technology.

This crisis, attributed to a defect in a software update from affecting Windows/Microsoft operating systems, has reverberated across sectors, with the healthcare industry anything but spared from the .

As healthcare professionals increasingly embrace artificial intelligence (AI) and electronic systems in healthcare, this incident raises critical questions about vulnerability and the measures needed to safeguard patient care.

Healthcare's Growing Reliance on Health IT and Clinical Informatics

A growing number of old and new tools have become increasingly mainstream in the healthcare workplace. involves using computer hardware, software, and infrastructure to record, store, protect, and retrieve clinical, administrative, or financial data in healthcare settings. Key components include electronic health records (EHRs) and health information exchange (HIE) systems.

combines science, medical treatments, and IT to enhance patient care, clinical decision making, and healthcare delivery. It focuses on managing and utilizing patient data and health information.

AI tools are rapidly advancing and can significantly impact health IT and clinical informatics. AI has the potential to revolutionize clinical documentation, streamline administrative tasks, and improve decision making. For instance, large language models can generate accurate discharge summaries and clinical notes from audio recordings of patient encounters, significantly on clinicians.

AI can also analyze vast amounts of , offering insights and recommendations that improve patient outcomes. Yet, this very reliance on technology introduces new risks.

The Care Consequences of Major Outages

The beauty of tech and AI systems lies in their potential to enhance efficiency and accuracy in clinical care. But what happens when these systems go offline?

The recent outage highlights the interconnected and vulnerable nature of systems around the world, affecting pharmacies, retail stores, and even public transportation. Meanwhile, healthcare providers faced significant disruptions in outpatient visits, surgeries, and brain monitoring procedures. In healthcare, downtime can have .

For example, the Microsoft crisis led to a major and prolonged downtime in multiple EHR systems, making this tool fully or partially unavailable at multiple hospitals across the globe. Due to the severity of the outage, previously scheduled non-urgent medical visits were canceled at the . This incident highlights a significant regional and national threat, as the U.S. already faces an access crisis with for ambulatory services, including consultations with neurologists and psychiatrists. It underscores the urgent need to prevent delays in providing care to communities in need.

It's worth noting that the CrowdStrike outage wasn't the only recent reminder of the need for resilience. The COVID-19 pandemic highlighted the fragility of this country's healthcare systems, as did the Change Healthcare attack in February. Any technological issues that prevent care access are operationally disruptive and pose major risks to patients.

Safeguarding Against Outages

Recent outage events underscore the critical need for robust and resilient infrastructure to ensure the seamless functioning of essential services and the importance of addressing potential vulnerabilities in our interconnected world.

Most people have become accustomed to the benefits and high reliability of health IT systems. It's like driving to work for a decade -- you face occasional delays due to traffic or minor issues, but you still get there. Now, imagine being told there is a day-long car ban, and you must walk or bike to work, yet you still have to deliver the same high-quality work as on a regular day. This change could cause major disruptions, from extreme delays to not being able to get to work at all.

To harness the benefits of health IT and future AI-powered systems while safeguarding against potential failures, healthcare leaders must develop and implement and disaster preparedness plans. Healthcare practices should update their to ensure patient care access during extended outages. Additionally, adopting technologies that emulate even the most unlikely scenarios will enable providers to be better prepared and more resilient.

As someone deeply involved in clinical informatics, AI, and value-based care, I have advised both for-profit and nonprofit organizations in the U.S. and abroad. As a busy clinician promoting new digital solutions while interacting with patients, trainees, providers, administrators, and technical teams, I find many of my best insights come from observing moments of crisis.

The recent outage served as a reminder that while tech and AI-assisted solutions are essential for advancing healthcare, everyone must approach their integration with caution. This includes rigorous testing, robust backup systems, and continuous monitoring to ensure these technologies rather than .

Healthcare administrators and clinicians must treat healthcare challenges related to IT downtime with the same urgency and concern as many approach flight cancellations. Just as a grounded airplane can disrupt travel plans, IT failures in healthcare can jeopardize patient safety.

Think of it as building a skyscraper: while the cutting-edge tech design is essential, a strong foundation and emergency systems are crucial to ensure safety. To prioritize the well-being of patients worldwide, it is essential to ensure that AI and electronic systems truly enhance patient care, making healthcare systems more efficient, resilient, and safe for all.

is a clinical neurologist at Mass General Brigham and associate professor of neurology at Harvard Medical School in Boston. Moura also serves as chair of the Quality Informatics subcommittee of the American Academy of Neurology and Chief Health Informatics Officer for the Epilepsy Foundation.