“I have Carbonite/Mozy backing me up, I’m all set”
“I just went to Best Buy and purchased an external drive, connected it to the server and I’m all set”
“I swap out a thumb drive every night and take it home with me.” (…and I’m all set!)
I talk to a lot of healthcare providers about what they use to back up their local server’s EHR data, and I have been surprised to learn that the answers above are very common. The purpose of this article is to educate the reader on why “over the counter” backup solutions are not sufficient for protecting the two core elements to a healthcare provider’s EHR environment:
- Business data
- The systems that support the Business data
About consumer grade backups
Readily available consumer grade backup products are an enticing option from their price standpoint – who can beat three years of Carbonite’s unlimited backup for $139? What about having the data backed up to a 3TB external drive right next to the server? Or, what could be more safe and cost effective than to back up Business data to a thumb drive, pop it in your pocket and take it home?
None of these options are sufficient means of protecting the systems that support your practice – If you are using a consumer grade backup platform to back up your data, then you’re running the following risks:
- Possible loss of all data due to the right data not being selected for backup
- Possibility that the data is being backed up improperly, which could result in corrupt data being restored
- Possibility that the backup solution is not even running, even if it was previously set up properly and known to function.
- Significantly longer downtime during a recovery scenario
What needs to get backed up?
When considering the environment that supports a server based Line of Business (LOB) solution, there is more to it than just the data.
Think about it like this: You have a server. Someone installed an operating system like Windows 2012 on the server. Then, someone configured the server for your environment by getting it configured on the network, set up the security and antivirus, created users, set up printers and created share drives for your team to access. That same person likely also installed any necessary software that is required to run on the server such as Adobe Acrobat, Terminal Services, DNS, DHCP, etc. Next, someone installed the LOB application on your server and configured your client workstations to connect to it. Only then does LOB data begin to get created! In other words, there are several pieces to the pie that make up the server environment, and without them, the solution will not function. Here is another way to look at it:
In general, when using a consumer grade backup solution, only 30% of the total backup is addressed. When installing these consumer grade backup products, they generally depend on the user to point them to any additional locations that data may exist to be backed up. Another way of saying this is that upon installing “over the counter” backup solutions, they will include to the user folders for all users on the system. This includes things like the Documents and Pictures folders, as well as some hidden folders that contain personalized settings. It does NOT include anything else by default – Everything represented in the pie chart above is generally excluded from an over the counter backup, and needs to be manually configured for backup.
Well, that’s easy enough to do, right? Just check with your IT support person and make sure that all of the Business data is included in your backup. Then you’re all set! Right? Wrong.
Where over the counter backup products fall (way) short
Backing up the right data
“Backup Management” refers to the review and confirmation that the backup system is indeed operating properly and backing up all the data that supports the systems.
Over the counter solutions cannot manage the backup. They are completely unable to determine if the right information is being backed up. They have no idea if “C:\Program Files\LOB Software\LOB Data” or “D:\Business Data” are folders that need to be backed up.
Making sure the backup is running
Probably the most common issue is where an over the counter product was installed at some point as a means of protecting critical data. A routine or process may be involved such as swapping out a disk or getting a confirmation email indicating the backup is OK. Then, in a recovery scenario, it is discovered that the backup has not been running for months or even years.
Without reviewing the backup log up close and personal, there is absolutely no guarantee that the backup solution is actually running. It needs to be reviewed regularly and proper alerts need to be set up to go to the folks who know how to fix the problem.
Backing up the data properly
Further, over the counter backup products are unable to determine if the data is safe to back up in its active state. What does that mean? If you back up data while it is being accessed by another program that is not backup friendly (also known as “application aware”), you will likely end up backing up data that will be corrupted and in an unusable state upon recovery. There is a chance that it may be recoverable, but you would have to send it to the LOB vendor to try and ply the data so it will recover, sometimes at great expense to the healthcare provider.
One of the most commonly overlooked aspect of backup is recovery time. Folks don’t think about it until they are in the middle of a recovery scenario wondering why it is taking so long!
Here is a relatively common scenario:
The server that supports your environment fails and your IT team deems it to be out of commission. For whatever reason, they are suggesting that you get a new server because (the warranty is expired / it will cost more to repair the current server than is justified / reason du jour).
Now, let’s look at the recovery process that would apply to the scenario above with some “over the counter” backup products. The following chart is being very conservative, assuming that no obstacles are encountered on the road to recovery:
* Assuming you purchase a server from a vendor who can provide one within one to two days, which is not typical.
** Assuming that there is 5GB or less of data to be downloaded and a fast internet connection (not DSL)
These are the typical steps that would be required in any case where the server would need to be replaced. Some backup utilities that use “mirroring” of the server might knock that number down closer to 55 hours, if they work properly.
An alternate common scenario is the one where the disk drive fails on the server and needs to be replaced. In this case, the time to recovery can be reduced to 24 hours or so assuming no obstacles are encountered along the way.
What is the best means of backing up?
The answer to this question generally boils down to two main factors:
- Your tolerance for downtime
- Your tolerance for loss of data
Consider the following chart that outlines the type of backup that might be the right fit based on the answers to the questions above:
“My business can tolerate some downtime or loss of data”
If your business can tolerate your local server being down and your team being without access to patient data for days on end, then a managed cloud backup solution may be the right fit for you. This is a service that your IT vendor may be able to provide for you. Keep in mind, however, that just having this solution in place is not enough: It needs to be reviewed and managed on an ongoing basis to ensure that it is capturing the right data and functioning as intended.
“My business cannot tolerate any downtime or loss of data”
If your business cannot tolerate downtime due to factors like a requirement for high availability of patient health information and scheduling resources, lost revenue, or the inability to service customers when the system goes down, then you need to consider a backup solution that provides a few functions:
- Local backup of all server instances in your environment
- Backups are converted into Virtual Machines that mirror the protected servers
- Ability to start up virtual instances of the protected servers in fifteen minutes or less
In addition, the two following elements are desirable for many providers that have indicated they cannot tolerate any downtime:
- Local as well as offsite backup of protected servers
- Ability to start up virtual instances of protected servers in the cloud