Table of contents

EHR downtimeWhy it happensThe hidden costHow to avoid itHow to prepareNext stepsAdditional resources

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HIPAA → EHR Downtime

EHR downtime: causes, hidden costs, and how to prepare

Every minute your EHR is down, your clinical and administrative workflows slow to a crawl. Orders stall, documentation piles up, and patient satisfaction can plummet. Whether it’s a system crash, cyberattack, or network issue, downtime disrupts care, strains staff, and erodes trust.

Let’s talk about what causes EHR downtime, how much it really costs, and what your organization can do to prevent and prepare for it.

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What is EHR downtime?

EHR downtime refers to any period when an electronic health record (EHR) system is unavailable or only partially functional. It can be planned (like during software updates) or unplanned (due to technical failures, cyberattacks, or infrastructure problems).

Even short outages can interrupt care delivery and create cascading issues throughout a hospital or practice.

Why EHR downtime happens

Most downtime stems from technical or infrastructure issues, but in healthcare, human and environmental factors often play a role too.

Common causes include:

Server failures or hosting outages – Many EHR systems rely on external hosting environments. If the underlying servers fail or experience overload, the EHR goes offline, even if the software itself is fine.
Software glitches and updates – Unstable patches, untested updates, or conflicts with third-party integrations can crash systems or corrupt data.
Network or internet disruptions – A weak or single internet connection can take cloud-based EHRs down instantly. Redundant connections are rare in smaller practices, making them especially vulnerable.
Cyberattacks – Ransomware and denial-of-service (DDoS) attacks are increasingly common. These can lock users out, encrypt files, or flood systems with traffic until they crash.
Power or environmental issues – Power outages, surges, or local disasters can take down servers and network equipment, even with good IT hygiene.
Human error – Mistaken configuration changes or unauthorized access attempts can trigger system lockouts or data loss.

The real cost of EHR downtime

The financial and operational impact is immediate. Clinicians revert to paper documentation, orders get delayed, and billing slows or stops entirely. Even brief outages can cost hospitals tens of thousands of dollars per hour in lost productivity and delayed services.

The hidden costs can be worse:

Patient safety risks – Incomplete records or medication errors can occur when information isn’t accessible.
Staff burnout – Manual workflows increase stress and fatigue, especially during emergency care.
Reputation damage – Patients notice when systems fail. Repeat outages erode confidence and lead to bad PR or online reviews.
Compliance exposure – Extended downtime can violate HIPAA availability standards if safeguards aren’t in place to protect data continuity.
Data integrity issues – After downtime, merging paper and digital records increases the chance of transcription errors or lost updates.

How to avoid EHR downtime

No organization can eliminate risk completely, but the right technical and operational strategies can dramatically reduce it.

Practical steps include:

Invest in reliable infrastructure – Ensure your servers and network hardware are maintained, monitored, and redundant. If you’re using cloud-based systems, verify your provider’s uptime guarantees and SLA.
Implement regular backups and testing – Backups only help if they’re current and restorable. Schedule regular failover and recovery tests to confirm your data can be quickly restored.
Strengthen cybersecurity – Enforce multi-factor authentication, patch regularly, and monitor for suspicious activity to prevent attacks that cause downtime.
Train staff on reporting and escalation – Non-technical users are often the first to notice issues. Empower them to report problems early through a clear process.
Evaluate your vendor’s hosting environment – Most EHR vendors host their software on third-party infrastructure. Ask who that provider is, where the servers are located, and whether the environment is HIPAA-compliant. Your vendor should be able to confirm redundancy, encryption, and uptime monitoring standards that align with healthcare best practices.

How to prepare for EHR downtime

Even the best systems will go down occasionally. Preparation is what keeps those moments from turning into crises.

Research supports this: a 2023 Abilene Christian University study found that proactive downtime planning increases staff confidence and improves safety during outages. Similarly, a review published in the Journal of Medical Internet Research found that structured training and communication plans reduce clinical errors and recovery time.

Best practices for preparation include:

Develop a written downtime policy – Document procedures for initiating paper workflows, verifying patient identity, and resuming EHR use.
Assign clear roles and responsibilities – Staff should know exactly who handles communication, record keeping, and system checks.
Keep paper forms and reference guides ready – Critical forms (admission, medication, orders, etc.) should be available and updated regularly.
Run downtime drills – Simulate outages to test readiness. Drills reveal workflow gaps and ensure staff can act quickly and confidently.
Maintain open communication channels – Set up alternative systems for alerts and updates (such as compliant text-based systems or internal radios) to keep teams informed during an outage.
Plan for data reconciliation – Have a structured process for re-entering data accurately once systems are restored.

how to plan for ehr downtime infographic

Next steps for dealing with EHR downtime

EHR downtime can’t be avoided entirely, but it can be managed and mitigated with smart planning and the right technology. Reliable infrastructure, clear protocols, and a compliant hosting partner form the foundation of uptime resilience.

To get started, review your downtime procedures and talk with your EHR vendor about their hosting and redundancy measures. If you don’t have a clear answer about where your system is hosted and how it’s protected, it’s time to dig deeper.

That’s where Liquid Web comes in. We offer the widest range of compliance-ready hosting solutions, with 24/7 support, seamless scalability, unbeatable speeds, and more. It’s infrastructure that just works.

Click through below or start a chat now with a HIPAA hosting expert to learn more.