💻 RXNT Downtime & EHR Outage Procedure

To establish a standardized process for maintaining safe patient care during planned or unplanned RXNT, internet, or electronic health record outages while ensuring complete documentation is entered once systems are restored.

Purpose

Electronic health record interruptions can affect scheduling, documentation, prescribing, communication, and patient safety. This procedure provides staff with clear guidance for maintaining operations during system outages while protecting patient information and ensuring continuity of care.

Policy

During any EHR or network outage, patient care should continue whenever it can be provided safely. Temporary paper workflows may be implemented until RXNT becomes available. Once service is restored, all required documentation must be entered into the permanent medical record as soon as reasonably possible.

Downtime Workflow

1️⃣ Identify the Outage
2️⃣ Notify Leadership
3️⃣ Implement Paper Workflow
4️⃣ Continue Safe Patient Care
5️⃣ Restore RXNT Access
6️⃣ Enter Documentation
7️⃣ Verify Completion

Examples of Downtime Events

Technology Failures

  • RXNT unavailable.
  • Internet outage.
  • Network interruption.
  • Computer hardware failure.
  • Printer or scanner failure affecting operations.
  • Server maintenance.

Utility Interruptions

  • Power outage.
  • Telephone outage.
  • Internet service disruption.
  • Building emergency.
  • Weather-related interruptions.

Clinical Impact

  • Unable to access patient charts.
  • Unable to prescribe electronically.
  • Unable to review laboratory results.
  • Unable to schedule patients.
  • Unable to document encounters electronically.

Immediate Staff Responsibilities

  • Determine the scope of the outage.
  • Notify the supervisor or clinic leadership.
  • Confirm whether the outage affects only one workstation or the entire clinic.
  • Protect patient privacy throughout downtime operations.
  • Retrieve approved downtime forms when needed.
  • Begin documenting care using approved paper documentation.
  • Communicate workflow changes to all staff members.
  • Continue providing care only when it can be performed safely.

Best Practice

Assign one individual to communicate with IT or RXNT support while the remainder of the team focuses on patient care. This reduces duplicate reporting and allows staff to receive consistent updates throughout the outage.

Paper Documentation During Downtime

When RXNT is unavailable, approved paper forms should be used to temporarily document patient care.

  • Patient registration information.
  • Clinical notes.
  • Vital signs.
  • Medication administration.
  • Orders and referrals.
  • Laboratory documentation.
  • Patient instructions.
  • Consent forms when applicable.
All handwritten documentation must be complete, legible, dated, timed, and signed according to clinic documentation standards.

Immediate Escalation Required

  • Extended RXNT outage affecting patient safety.
  • Complete internet or network failure.
  • Power outage affecting clinical operations.
  • Inability to access critical patient information.
  • Suspected cybersecurity incident.
  • Medication safety concerns during downtime.
  • Any outage preventing safe patient care.
Leadership should determine whether patient appointments should continue, be delayed, or be rescheduled based on the severity and expected duration of the outage.

System Restoration Process

Once RXNT and related systems become available, staff should transition back to normal electronic workflows in a structured manner to ensure that no patient information is lost or omitted.

💻 Systems Restored
🔐 Verify User Access
📝 Enter Paper Documentation
✔️ Review for Accuracy
📁 Scan Paper Records
✅ Resume Normal Workflow
TNC Standard

Electronic documentation should be completed as soon as possible after system restoration. Every patient encounter that occurred during downtime must be accurately reflected within the permanent medical record.

Documentation Recovery

Paper records created during downtime must be entered into RXNT completely and accurately.

  • Enter provider documentation into the patient's chart.
  • Record vital signs and clinical observations.
  • Document medications administered.
  • Enter laboratory and imaging orders.
  • Complete referrals and follow-up instructions.
  • Document patient education provided.
  • Record visit diagnoses and procedures.
  • Upload scanned downtime forms into the patient's chart.

Best Practice

When entering documentation after an outage, clearly indicate that the encounter occurred during an RXNT downtime event and that the electronic documentation is being completed following system restoration.

Medication & Prescription Safety

Special attention should be given to medication safety during and immediately after downtime events.

  • Verify allergies before prescribing medications.
  • Confirm current medication lists whenever possible.
  • Review handwritten prescriptions for completeness.
  • Document all prescriptions issued during downtime.
  • Reconcile medications once RXNT access is restored.
  • Notify providers of any medication discrepancies.

Immediate Escalation

  • Medication error identified.
  • Duplicate prescription issued.
  • Unable to verify allergies.
  • Controlled substance concerns.
  • Prescription cannot be validated.
  • Patient safety may be compromised.

Patient Communication

Patients should receive timely, transparent communication regarding any delays caused by an electronic system outage.

  • Explain that the clinic is experiencing a temporary technical issue.
  • Provide realistic expectations regarding wait times.
  • Reassure patients that care will continue whenever safely possible.
  • Notify patients if appointments require rescheduling.
  • Maintain professionalism and empathy throughout the event.
  • Document significant communication when appropriate.
Staff should never speculate about the cause of an outage or provide technical details that have not been confirmed by leadership or IT.

Quality Assurance

Clinical Staff

  • Maintain complete paper documentation.
  • Protect patient safety.
  • Enter documentation after restoration.
  • Verify encounter accuracy.
  • Report any patient care concerns.

Front Office

  • Manage paper registration forms.
  • Maintain appointment tracking.
  • Communicate delays to patients.
  • Assist with scanning completed records.
  • Support restoration efforts.

Leadership

  • Coordinate clinic response.
  • Communicate with IT and RXNT support.
  • Determine operational status.
  • Monitor patient safety.
  • Review recovery completion after restoration.

Downtime Recovery Checklist

✅ Notify leadership immediately
✅ Implement approved downtime procedures
✅ Use paper documentation for all patient encounters
✅ Protect patient privacy throughout the outage
✅ Continue care only when safe to do so
✅ Verify RXNT functionality after restoration
✅ Enter all documentation into RXNT
✅ Scan downtime forms into the medical record
✅ Verify documentation accuracy and completeness
✅ Resume standard electronic workflows

Sawubona Standard

Technology interruptions should never compromise patient safety or compassionate care. At The Neighborhood Clinic, we respond to downtime with organized workflows, clear communication, and meticulous documentation. By maintaining continuity of care during system outages and ensuring every encounter is accurately documented afterward, we uphold our commitment to safe, reliable, and patient-centered healthcare—regardless of the technology available.