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When systems go down, care still has to move.
Who receives the critical result? How does a medication question reach the right person? Start with the work your hospital needs to keep moving.
What needs to keep moving?
Choose a workflow. See who acts next, where escalation belongs and what completion should look like.
Critical Results
Route critical results to an accountable clinician when the EHR cannot deliver them.
Critical Results
Route critical results to an accountable clinician when the EHR cannot deliver them.
Close the result loop during downtime
When the EHR is unavailable, a critical result still needs a documented route from the laboratory to the clinician responsible for acting on it. Backline routes results by role, tracks acknowledgment and escalates through your approved coverage chain, so follow-up survives a shift change.
Illustrative map. Adapt it to your hospital’s approved downtime process.
Medication Coordination
Keep medication questions, verifications and orders moving when the usual pharmacy queue is unavailable.
Medication Coordination
Keep medication questions, verifications and orders moving when the usual pharmacy queue is unavailable.
Connect nursing, pharmacy and prescribers
A new medication question still needs to reach the right pharmacist, and the answer needs to reach the nurse and prescriber. Backline gives teams a secure way to raise, route and resolve medication questions while keeping visibility into what is still open.
ED & Admissions
Coordinate admission decisions, bed assignments and patient movement when tracking boards go dark.
ED & Admissions
Coordinate admission decisions, bed assignments and patient movement when tracking boards go dark.
Keep patient flow visible across teams
When tracking boards and work queues are unavailable, admitting teams still need to know who is waiting, who accepted the patient and where they are going. Backline connects the ED, admitting clinicians, bed management and receiving units around each admission.
Consults & Shift Handoffs
Make sure open consult requests and outstanding work still have an owner after a shift change.
Consults & Shift Handoffs
Make sure open consult requests and outstanding work still have an owner after a shift change.
Hand off work, not just information
During downtime, consult requests and open items are easy to lose between shifts. Backline routes consults to the on-call specialist by role and keeps outstanding work assigned as responsibility moves to the oncoming team.
Transfers & Discharge
Coordinate patients leaving the hospital when the usual partner, service or system cannot respond.
Transfers & Discharge
Coordinate patients leaving the hospital when the usual partner, service or system cannot respond.
Keep transitions moving across organizations
Transfers and discharges depend on people and services outside the hospital. Backline provides a secure way to communicate with receiving facilities, transport and post-acute partners while giving the hospital team visibility into where each transition stands.
Incident Command
Give incident command visibility into what is moving, what is stuck and who owns it.
Incident Command
Give incident command visibility into what is moving, what is stuck and who owns it.
Connect unit-level work to the command center
Leaders need more than status updates during an outage. Backline connects incident command with department leads and unit teams so leaders can communicate at scale, assign work, escalate issues and track unresolved items through recovery.
The situation changes the conversation.
An EHR outage, a network interruption and a missing vendor service leave different resources available. Explore the dependencies behind each one.
The EHR is unavailable
Orders, patient context and the usual work queues may be unavailable. Your teams still need an approved way to record, assign and follow up care.
The hospital network is isolated
Containment can take hospital Wi-Fi, single sign-on and familiar communication channels out of the workflow together.
A critical vendor is disconnected
A hospital can lose a communication, diagnostic or administrative service even while its own EHR remains available.
Systems are coming back
Applications may return at different times. Downtime requests, records and unresolved handoffs need a deliberate transition back.
Bring your actual environment into the discussion.
The same workflow can depend on different people, services and technology at each hospital.
Hospital continuity, explained.
A real-world look at what it takes to keep care moving when systems go down.
Frequently asked questions
Use these examples to frame a discussion around your hospital’s approved downtime process.
What is healthcare business continuity?
Healthcare business continuity is the ability to keep essential patient care and the work around it moving when systems, networks or vendor services are interrupted. It covers approved patient information, responsible people, available services, communication and unfinished work, not just technical recovery.
What is EHR downtime?
EHR downtime is any period when the electronic health record is partially or fully unavailable, whether planned for maintenance or unplanned because of an outage, cyberattack or vendor issue. During downtime, orders, results and work queues may need to move through approved backup processes.
How should hospitals communicate critical results during EHR downtime?
Hospitals should maintain a documented route from a verified result to an accountable clinician, with acknowledgment, escalation through an approved coverage chain and follow-up that survives a shift change. Any unresolved item should stay assigned until the record is reconciled.
What should a hospital downtime plan include?
A downtime plan should define which work must continue, who owns each step, which information and communication routes remain available, how escalation works, and how downtime activity is reconciled when systems return. Plans should be specific to the type of interruption.
How is a network isolation event different from an EHR outage?
In an EHR outage, other tools may still work. When a hospital network is isolated, for example during cybersecurity containment, Wi-Fi, single sign-on and familiar communication channels can be unavailable at the same time, so teams need routes that do not depend on them.
What happens when systems come back after downtime?
Applications may return at different times. Hospitals need a deliberate transition that reconciles downtime orders, results and documentation, and confirms that every open request or handoff still has an owner.
How can Backline support hospital continuity?
Backline coordinates clinical communication and workflow so the next action has an owner, escalation follows your approved rules and unfinished work stays visible. Your hospital should validate how Backline fits its environment, approved downtime process and vendor dependencies.
How does this relate to the official SAFER Guides?
These are original discussion aids. The official SAFER Guides from ONC provide structured self-assessments, including contingency planning. Use them with your hospital’s approved policies and current vendor documentation.
Connect the conversation to the workflow.
Explore Backline’s approach to clinical communication and workflow coordination, then discuss the dependencies your hospital would need to validate.
We'll map how critical work moves during downtime today and identify where Backline can create clearer ownership and visibility.