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A Necessary Primer on EMR Server and
Database Backups
Please note that HIPAA regulations require a
backup and recovery plan that includes a daily offsite backup of
your EMR (Electronic Medical Records) data. This requires that
at the very least, you should backup your database containing your
patient records and store it offsite on a daily basis. In addition,
it is usually a good idea to do monthly full backups of your server
and store it at an offsite location in case of a disaster. These
steps will help to get you up and running quickly in case of a
disaster.
In order to comply with HIPAA requirements, our
specific recommendations are listed below.
Weekly/Monthly Full Server Backups:
At a minimum, we recommend a full server backup on
a monthly basis. Weekly backups are even better, if possible. In the
event of a complete server crash, this, in combination with the
latest database backup should have you up and running in a very
short time.
Daily Database Backups:
There are several options you can follow to meet
this requirement. Each of these is listed below with a recommended
cycle time.
Daily Tape/CD/DVD Backups
If your EMR server has a built in tape drive, you
may want to take this route. In this case, you will have to purchase
a minimum of seven tapes, each with the capacity to hold a full
daily backup of the database. Each of these tapes will be labeled
with a day of the week like 'Monday', 'Tuesday' etc. Each tape will
be inserted into the tape drive on the day labeled. You can set the
built in database backup utility of SQL Server to backup to this
media every day at a specified time. This media will then need to be
swapped out every day and taken off site. This will ensure that you
have at least 7 days of backups available of the database.
Pros
of this approach:
Cons
of this approach:
-
This
is the slowest method for backups and takes the longest time
-
Tape
media (at least in my experience) is not as reliable as using
External Hard Drives or CD or DVD media
-
This
involves the most manual involvement and needs you to swap out
and take the media off site every day
-
As
the backup size of your Electronic Medical Records file grows,
you could run into space issues on the media, forcing you to
switch to higher capacity media such as external hard drives
etc.
-
Tape
drives are expensive and add to the initial investment
Daily External Hard Drive/Thumb Drive backups
If your server has available USB slots, you may
be able to attach external compact USB hard drives or high
capacity thumb drives to use as the backup media. This is easier
to use and you can create folders in the drive that each day of
the week backs up to. You can do the backups using the built in
SQL Server backup utility.
Pros
of this approach:
-
Easier
to setup and use and easier to carry in your pocket
-
Once
the routine is established, you just need to follow the schedule
-
More
reliable than tape backups and as reliable as CD or DVD media
Cons
of this approach:
-
You
still need to remember to swap out the drives daily
-
Though
the media is more reliable, it is still susceptible to failure
-
Though
your EMR backup may physically be off site, you are opening
yourself up to the possibility of misplacing or losing the
backup media (a problem with HIPAA Regulations)
Automated Online Backups
This is the third option. Here you install a
client software on your EMR Server that automatically launches a
backup to a remote server through the web. The backup software
should be carefully picked to make sure that it meets the
encryption requirements for HIPAA.
Pros
of this approach:
Cons
of this approach:
What do we recommend? It is our experience that
you can never have too much redundancy in data backups. I
recommend using at least 2 of the above 3 methods, with automated
online backups being one of them. This will serve as your 'safety
net' in case your primary local backup method fails. The loss of
even a small amount of data can be a significant blow to a
doctors' office, resulting in weeks of catch up work. It is far
better to insure against that by putting in redundancy in your
backup plan, than to fret about it after the fact.
Naveen
V.
www.emr-electronicmedicalrecords.com
DoctorsPartner
EMR and PM
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