Disaster Recovery Tips for Dental Practices

It can happen at any time
Lessons learned from 9/11, Katrina and the 2003 blackout have awakened many New Yorkers to the reality that a disaster can touch this city at any time, leaving behind a devastating aftermath in its wake. In recognition of this fact, HIPAA Final Security Rule section 164.308, under Administrative Safeguards, requires covered entities to establish a disaster recovery program for the protection and accessibility of all protected health information (PHI). The deadline for compliance was April 21, 2005.

To help prepare yourself and your practice for a disaster event, we offer a few practical tips you may want to put into operation. At the conclusion of this article you will also find a list of vendors and consultants who can assist you in developing a disaster recovery program for your practice...and home.

Go paperless
The first step in protecting your practice is to go paperless - this will include patient records, billing and accounting information, correspondence, radiological and photographic images. If you are already using digital x-ray technology in your practice, you're already half way there. Going paperless means that all your critical data is stored in digital files and can be backed up to recorded media such as optical disk, magnetic tape or hard drives.

To help insure the safe keeping of their data, some dentists backup and store their critical files in a fire-proof safe on premises. While this provides adequate compliance with HIPAA's Final Security Rule, it may not protect your data against terror-related events. In this regard, HIPAA Final Security Rule requires covered entities to "protect the availability of EPHI by establishing a contingency plan." Storing your electronic protected health information (EPHI) in a fireproof safe may not meet this requirement as your safe may become inaccessible due to biological or radiological contamination. To meet this possible threat, your disaster recovery program should include remote or off-site backup of your data files.

"Remote data backup is not only for ensuring against total or catastrophic loss of data," comments Chuck Piluso, president, of Data Storage Corporation. "It is also a cost-effective way to maintain business continuity in the event of a computer hardware failure resulting in partial data loss."

Shopping for a remote backup vendor
What should you look when shopping for a remote backup vendor? There are five key points you want to consider: 1) Do they provide continuous or hourly data protection? 2) Do they have redundant file servers in protected data centers in low-threat areas of the country? 3) Are they using third party vendors to backup their file servers, i.e., Amazon, Iron Mountain, etc? 4) Can they assist you in ensuring that your practice meets HIPAA compliance? 5) Can they provide total data security with file access limited only to you and authorized staff members?

When shopping for a remote or off-site backup vendor, be sure that they can protect your data with continuous and not just hourly backups. This ensures that you don't lose even a minute's worth of information. You will also want to know if your vendor's file servers are located in protected data centers located at least 1,000 miles away from your practice. This helps ensure that they too will not be affected by the same local disaster, such as a flood or earthquake. Does this vendor rely on a third party vendor to backup their servers or do they own multiple data centers for data redundancy? You may want to opt for the vendor that maintains their own data centers. Finally, look for a vendor experienced in HIPAA security issues that will work closely with you to make sure your practice meets compliance.

Power failures
For those New Yorkers trapped in elevators and stalled subway cars, the summer blackout of 2003 was a living nightmare. While state and city planners have taken steps to avert similar disasters, major power losses experienced earlier this summer is a clear indication that New York's power problems are far from over. With this in mind, you may want to seriously consider purchasing a backup generator to provide emergency power for their practice.

What is a backup generator?
A backup generator is an auxiliary power plant that can be use to keep your practice up and running in the event of a power outage. Depending on your power needs and the size of your budget, you can purchase a generator that can provide total or partial emergency power for your practice. Like a central air conditioning unit, a backup generator is located outdoors and is usually powered by natural or propane gas-diesel-fueled generators are also available but generally used for industrial applications . When a power outage occurs, a transfer switch automatically starts the generator to provide emergency power, usually within 10 seconds.

Shopping for a backup generator
Before purchasing a backup generator, it is important to consider your options. The first and most important decision to make is whether you want to provide backup power for your entire practice or just key circuits. For example, if you don't want to power up your whole office, you can supply power to one or two computer stations, your x-ray equipment, sterilization equipment and perhaps one or two treatment rooms. This will give you the ability to complete a sensitive procedure in the event of a prolonged power outage.

"When shopping for a backup generator, make sure that the contractor you select can secure all the permits necessary to install the unit," says Sam Chernin of Power Back On. "They (the contractor) will also need to do a load analysis to determine the amount of power needed to start and operate your most energy-hungry appliances, as well as your overall electrical requirements. Generators operate most efficiently at about 80% capacity, so if your operating load is 16 kW (16,000 watts), purchase a 20 kW unit (20,000 watts)."

Disaster Recovery Checklist
The biggest disaster for any business is failure to plan for one. Anticipating and planning for a disaster will help ensure the survivability and speedy recovery of your practice. Here are a few checklist items you will want to include in your disaster recovery program.
1) Data recovery and continuity
2) Disaster preparedness and CPR training for your staff
3) Review and update your insurance coverage
4) Plan for operating from an alternate location
5) Consult with a contractor on anticipated office repairs
6) Plan for equipment repair and rental
7) Have an emergency contact phone list in a secure location

Another item you may want to include as part of your disaster recovery program is the creation of a "What to do in a disaster" flyer for your patients. This flyer would outline the steps you have taken to provide your patients with emergency dental care during a local disaster. This will go a long way in building a closer bond between you and your patients, as well as being a powerful sales tool for generating new business.

Disaster Recovery Resources

Data Backup Services
Data Storage Corporation
(212) 564-4922
www.dscorp.net

Eagle Software, Inc.
(800) 477-5432
www.eaglesoft.com

Backup Generators
Power Back On
www.powerbackon.com
877-865-8766

Cooper Power Systems
(732) 774-1058
www.cooper-electric.com

Disaster Recovery Planning
American Dental Association
www.adafoundation.org/prof/prac/disaster/index.asp

The Florida Dental Association's Five Step Guide for Disaster Preparedness and Recovery
www.ladental.org/Hurricane%20Info/FDHF-DisasterHandbook05-print.pdf