How Does dbtech Handle Downtime at a Facility That Runs Two Different EHR Systems Simultaneously?
Running two EHR systems simultaneously at a single facility is more common than most people outside healthcare IT realize. A hospital may run Epic for its acute care workflows while using a separate behavioral health EHR for its psychiatric unit, which has distinct documentation and regulatory requirements that the primary EHR was not designed to support. A long-term care wing may operate on a different platform than the adjacent acute care hospital. A cancer center may use a specialty oncology system alongside the main enterprise EHR.
In each of these scenarios, a downtime event that affects one system may or may not affect the other, and the downtime preparedness requirements for each system are distinct. The question for dbtech is whether the solution can accommodate this complexity rather than requiring the organization to choose which system it will support during a downtime event.
How dbtech Supports Dual-EHR Environments
dbtech’s architecture supports dual-EHR environments by configuring separate HL7 integrations for each EHR system at the facility. Each integration feeds patient data from its respective EHR into the appropriate downtime workstations, which are deployed in the departments served by that EHR. The acute care workstations receive their data feed from the primary hospital EHR. The behavioral health unit workstations receive their data feed from the behavioral health EHR. Each integration operates independently and does not require the two EHR systems to share data with each other.
From a practical standpoint, this means:
- A downtime event affecting only the primary hospital EHR activates the downtime procedures in the acute care departments while the behavioral health unit continues operating normally on its own EHR
- A downtime event affecting only the behavioral health EHR activates the behavioral health unit’s downtime procedures while the rest of the facility continues on the primary EHR
- A facility-wide network outage that takes both EHR systems offline simultaneously activates downtime procedures across all departments, with each department using workstations configured for its specific EHR environment
- The forms libraries for each set of workstations can be configured separately to reflect the different documentation requirements of each clinical environment, with acute care consent forms and registration workflows distinct from behavioral health documentation forms that comply with 42 CFR Part 2 and other behavioral health-specific regulatory requirements
The Behavioral Health Specific Consideration
Behavioral health is the most common scenario for a dual-EHR environment, and it carries specific compliance considerations that affect both the downtime solution configuration and the forms library. Documentation in behavioral health settings is governed by distinct confidentiality requirements, including 42 CFR Part 2 for substance use disorder treatment records and various state-specific behavioral health confidentiality laws. These requirements affect what information can be displayed to which staff members and how consent documentation for information sharing must be structured.
dbtech’s access control configuration can be set to reflect these requirements at the workstation level, limiting behavioral health patient data visibility to staff authorized to access it and configuring the behavioral health forms library with the consent and documentation forms specific to that regulatory framework. This configuration is handled during the implementation process in coordination with the organization’s behavioral health compliance team. For organizations also considering dbtech for their behavioral health downtime needs, see our related post on how dbtech can support downtime for a behavioral health or psychiatric unit.
The Monitoring View for a Dual-EHR Facility
From the central IT team’s perspective, a dual-EHR deployment at a single facility appears as two separate integration configurations in the dbtech monitoring dashboard. Both integrations are visible in the same dashboard view, with separate sync status indicators, data currency timestamps, and HL7 health metrics for each. This allows the IT team to monitor both integrations from a single interface and identify any issues with either integration before they affect downtime readiness.
To discuss how dbtech would be configured for your specific dual-EHR environment and what the implementation process looks like, request a demo or contact our team.