Gary Baulos woke up at 3.30am on Friday for open heart surgery to fix eight blockages. A call from the hospital in Paducah, Kentucky, soon altered his plans. The procedure would be rescheduled because of a global technology outage that was derailing operations.
The 73-year-old retiree made the best of the situation, grabbing a breakfast of bacon, eggs, and pancakes at an IHOP before heading home to Marion. “I guess I’ll do it some other time,” he said.
Not everyone was as sanguine. Lydia, who asked that her last name be withheld for privacy reasons, had her surgery at the University Hospital of Maryland cancelled. A waiting room full of patients and family members all got the news that operations were being placed on hold.
Lydia, who needed the surgery so she could continue dialysis, said many people were upset after spending time and money and taking off work to get to the hospital. She still hasn’t been given another slot.
Limited access
They are among scores of patients whose medical care was upended, as health systems around the world adjusted to ensure emergency services were available. The digital outage limited access to patient charts, derailed phone services, and shut down computer systems and workstations.
Many hospitals resorted to using handwritten records in the wake of a digital outage that roiled vital resources from air travel to emergency services. Centres like Banner Health in Phoenix and Boston-based Mass General Brigham warned it was affecting patient care. Ambulances in Dallas couldn’t automatically alert emergency rooms about patients they were rushing in, while 911 operators in New Hampshire at one point could see calls but couldn’t answer them.
In the UK, National Health Service general practitioners had trouble accessing scans, blood tests and patient histories after the global IT problems hit a system used for booking patient appointments and checking medical records.
CrowdStrike
The cyber fiasco, the result of a flawed CrowdStrike Holdings Inc software update that took down Microsoft Corp systems, ripped through airports, clinics and financial networks worldwide in a stark reminder of universal dependence on properly functioning software. Health facilities from New York to London to Paris suffered under the strain.
Hospitals running the gold standard electronic health record system from Epic Systems Corp were hobbled by the update. While it didn’t affect Epic’s software or services directly, it caused technical issues that prevented healthcare providers from using the systems, the company said.
The issue began after midnight central time and “causes servers and workstations to crash and get stuck in a reboot loop upon attempting to restart,” Epic said in a message to customers that was viewed by Bloomberg.
An Epic spokesperson said “we can help customers monitor system activity and prioritize servers but unfortunately we are largely waiting on updates from CrowdStrike, like everyone else.”
Anaesthesia pause
The impact varied across the world. Some health systems were largely untouched, while others saw technology, communications and service provider disruptions that led to delays or cancellations, said John Riggi, national advisor for cybersecurity risk at the American Hospital Association, in an emailed statement.
Baptist Health in Kentucky, where Baulos was originally scheduled for surgery on Friday, said the situation hindered normal operations. It cancelled non-emergency procedures as it works to resolve the issue and asked for patience and cooperation in a statement.
Memorial Sloan Kettering Cancer Center in New York initially paused the start of procedures that required anaesthesia, though surgical cases subsequently resumed. The Mass General Brigham system that includes some of Boston’s most prestigious Harvard-affiliated hospitals said it was cancelling elective procedures Friday as it addressed the computer issues.
Pittsburgh-based UPMC said it intervened early in the incident and that fewer than 10% of its Microsoft Windows-based devices were impacted at some facilities. Patient care was unaffected, the hospital system said.
University Hospital Schleswig-Holstein in northern Germany cancelled elective procedures and closed outpatient clinics early Friday. It was restarting systems in the afternoon and said it planned to resume normal operations by Monday.
Self check-ins for appointments at the entrance were hit at Paris Saint-Joseph hospital, where employees began personally directing patients to their appointments on arrival.
The NHS said it was also resorting to low-tech measures to keep running.
The health system “has long standing measures in place to manage the disruption, including using paper patient records and handwritten prescriptions, and the usual phone systems to contact your GP,” an NHS spokesperson said.
Farah Jameel, a doctor at the central London Museum Practice, said that while some practices seem to have been able to use a workaround to access affected systems, her practice was shut out.
“I still can’t access blood tests, I can’t access imaging, I can’t access their past records so I can’t really make a comprehensive plan at the moment,” she said in an interview. For patients with complex medical histories “it’s quite unsafe,” Jameel said. The GP fears that the backlog will accumulate, adding that the longer the system was affected “the more impact to patient care”.
Nikita Kanani, a GP in London and former medical director of primary care for NHS England, said that some doctors were having to do face-to-face triage and then fill in handwritten notes and prescriptions. Doing this all without access to blood tests or imaging results was “risky,” she said. GPs haven’t been given any timeline for when the situation would be resolved, she said in an interview.
