what is a business continuity plan in healthcare

Emergency Management

Business continuity for clinical practices.

Clinical practices are vital to the health and wellbeing of both the University and the countless individuals that seek treatment and care. Disasters and other emergencies can threaten a health care organization’s ability to maintain operations and provide services. Whether it is a major disaster or a localized incident, patient care can suffer. It is vital that clinical practices be prepared to address the unique needs of their operations regardless of the disaster. A business continuity plan will help minimize and possibly even prevent serious consequences and down time following a disaster or major disruption. Watch the video below for more information about the value of business continuity planning for clinical practices.

Business Continuity Planning Guide

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Continuity of Operations (COOP)/ Business Continuity Planning Topic Collection August 18, 2023

Topic Collection: Continuity of Operations (COOP)/ Business Continuity Planning

• Technical Resources
• Recovery and COOP
• Continuity of Operations (COOP)/ Business Continuity Planning

Disasters and public health emergencies can have a significant impact on healthcare personnel and facilities. Plans and mitigation efforts that allow medical facilities and providers to sustain their mission, core essential functions, and services for patients already receiving care, as well as respond to potential surges in patients with space, staffing (including leadership), and equipment/supply issues are required. The goal is to ensure continuity of operations and facilitate operational and financial recovery.

Continuity of Operations Planning (COOP) is the term favored by public and government entities for mitigation and planning strategies that create resilience and allow services to continue to be provided in the face of a range of challenges. Business Continuity Planning (BCP) is a similar term more often used in the private sector that focuses on both maintaining service delivery and receiving payment for those services provided. BCP in the past often referred to computer systems but now applies to all vulnerable resources. The resources that follow highlight selected plans and planning guidance, lessons learned, tools, and promising practices for healthcare facility BCP. Additional related resources may be found in the Hazard Vulnerability/Risk Assessment , Cybersecurity , Electronic Health Records , Recovery , and Utility Failures Topic Collections.

Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category.

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• This item doesn't have any comments
• Emma Poon This is a better link for FEMA's most current continuity guidance: https://www.fema.gov/continuity-resource-toolkit 7/1/2020 9:33:51 AM
• J Warren Billett This link is broken. 7/11/2022 2:29:15 PM

Education and Training

Event-specific lessons learned, general information, guidance/guidelines, information technology (it) and utility issues.

• bob johnson This response missed RPO as part of the discussion and cost factor. 11/26/2019 1:26:39 AM

Non-Hospital Setting Continuity Planning

Plans, tools, and templates.

• Mike Staley Template not available 4/27/2017 2:04:00 PM

Agencies and Organizations

This ASPR TRACIE Topic Collection was refreshed and comprehensively reviewed in August 2019 by the following subject matter experts (listed in alphabetical order): Eric Alberts , EM, CHS-V, FPEM, FPEM-HC, CDP-1, CHPP, CHEP, SEM, CFRP, FABCHS, Manager, Emergency Preparedness, Orlando Health, Inc. (Hospital System); Peter Brewster , U.S. Department of Veterans Affairs, Program Manager, Education and Training; John Hick , MD, HHS ASPR and Hennepin County Medical Center; Onora Lien , Executive Director, Northwest Healthcare Response Network; Mary Massey , BSN, MA, PHN, VP, Emergency Management, California Hospital Association; and Mary Russell , EdD, MSN, Healthcare Emergency Response Coalition, Palm Beach County Florida.

I t was comprehensively reviewed in August 2015 by the following subject matter experts (listed in alphabetical order): Eric Alberts , BS, FPEM, CHS-V, CDP-1, CHPP, CHEP, SEM, CFRP, FABCHS, Manager, Emergency Preparedness, Orlando Health, Inc. (Hospital System); Peter Brewster , U.S. Department of Veterans Affairs, Director, Education and Training; Benjamin Dauksewicz , MA, CEM, Mount Sinai St. Luke’s–Roosevelt; Natalie N. Grant , MPH, Program Analyst, HHS ASPR, Office of Emergency Management (OEM), Recovery, and Hurricane Sandy Health & Social Services Recovery Support Function Field Coordinator; John Hick , MD, U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response (HHS ASPR) and Hennepin County Medical Center; Carol Jacobsen , RN, Director, Public Health Programs, Ohio Hospital Association; Bill Mangieri , CBCP, CHEP, Field Project Officer Region VI, National Healthcare Preparedness Program, HHS ASPR, OEM; Mary Russell , EdD, MSN, Emergency Services, Boca Raton Regional Hospital; and Matthew L. Smith , Chief, Continuity of Operations Branch, HHS ASPR, OEM, Division of Resilience.

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Why Is Business Continuity Important to Healthcare?

Potential disruptions to healthcare organizations’ continuity, the growing threat of ransomware in healthcare, why healthcare is a prime target for cyberattacks, how healthcare business continuity directly impacts lives, costs of downtime in the healthcare sector.

• Ensuring Healthcare Business Continuity

Benefits of Business Continuity Planning

Healthcare business continuity faqs, what is healthcare business continuity.

• 1. Why Is Business Continuity Important to Healthcare?
• 2. Potential Disruptions to Healthcare Organizations’ Continuity
• 3. The Growing Threat of Ransomware in Healthcare
• 4. Why Healthcare Is a Prime Target for Cyberattacks
• 5. How Healthcare Business Continuity Directly Impacts Lives
• 6. Costs of Downtime in the Healthcare Sector
• 7. Ensuring Healthcare Business Continuity
• 8. Benefits of Business Continuity Planning
• 9. Healthcare Business Continuity FAQs

Business continuity is the ability for an organization to maintain critical operations in the event of an unanticipated situation, such as a natural disaster, human error, or a cyberattack.

While business continuity is essential for any organization in any industry, the implications of service disruptions that affect day-to-day healthcare operations are both unique and potentially devastating.

The mission-critical nature of everything done in a healthcare setting means that uninterrupted operations is an absolute requirement, and there must be systems, processes, and rules in place in the event of a disruption.

Providing medical care in a hospital, clinic, ambulatory setting, or through a telemedicine hook-up is a no-compromise, no-short-cuts requirement. No organization can afford to put its patients — or its business operations — at risk by having an unplanned service outage of medical and other everyday operations.

While there are many potential contributors to business continuity risks in healthcare, cybersecurity is particularly problematic. Failure to properly anticipate and respond to cyberattacks can result in financial losses, regulatory penalties, and poorer patient outcomes.

Consider what happens if connected devices such as endpoints, servers, smart medical equipment, and entire networks cannot create, share, or store information about a patient’s health. Practitioners and medical staff will not have access to up-to-the-second patient information or their medical history.

Also, if critical infrastructure such as power equipment, HVAC systems and facility-wide communications networks are unavailable even for minutes, providers cannot conduct medical or business activities.

The interconnected nature of healthcare operations ranging from large, sprawling healthcare systems to doctors’ practices means there are numerous risks and vulnerabilities that can affect normal operations.

These include natural disasters, power outages, physical security breaches, and human error. Each of these represents the potential to infect a wide range of operations including healthcare delivery, financial systems, clinical activities, research, and more.

Cyberattacks, however, are dramatically rising and impact healthcare organizations’ business continuity in substantial ways. According to research with healthcare industry IT and security leaders, 89% of their organizations suffered an average of 43 attacks over the past year — nearly one attack each week.

Those cyberattacks take many different forms — malware , identity and credentials theft, social engineering, advanced persistent threats, zero-day attacks, and ransomware. Cyberattacks in the form of data breaches, compromised data integrity, physical security threats, and interruptions of critical infrastructure operations threaten to disrupt business continuity.

Ransomware is a fast-growing and particularly challenging cybersecurity threat for all industries. Unit 42 found that ransomware was the most-often-confronted attack in the prior 12 months.

Healthcare organizations face ransomware threats at an extremely high rate, according to Unit 42’s incident response data, adding that hackers demanded an average ransom of $1.4 million from healthcare organizations.

Ransomware is particularly devastating to healthcare operations because organizations understand that protected health information (PHI) and personally identifiable information (PII) cannot be compromised, making them extremely vulnerable to hackers’ demands. Hackers also often attack systems controlling healthcare delivery such as cardiology, radiology, oncology, and more. If those systems go down, the impact on health outcomes will be devastating.

Healthcare organizations face unique challenges because of the extremely high value of patient healthcare data, such as PII and PHI, to hackers. Hackers often target healthcare organizations because hospitals and other care facilities are highly motivated to sidestep anything that disrupts medical and business operations.

Another key issue is physical infrastructure. Health systems contain a large number of diverse endpoints — not just servers, desktops, and notebooks. A growing number of smart medical devices now are connected to hospitals’ networks, and many internet of medical things (IoMT) devices often lack the same level of protection as traditional computing endpoints.

Also, the growing trend toward telemedicine means patients typically are using their own consumer-grade devices, networks, and cloud services, all of which may lack the cyber resilience delivered by internal IT and security teams.

The cost of ensuring data security in the healthcare industry is substantial in several ways: financial, operational, legal, regulatory, and brand reputation. But few would debate that the biggest risk in unplanned business interruptions is the direct impact on patient health and lives.

If heart monitors, infusion pumps, or dialysis machines fail because of a cyberattack, patients’ health can be severely compromised. The same is true for digital critical infrastructure that controls power, HVAC, and communications systems.

For example, if Emergency Department operations are compromised, patients might not receive full assessments, diagnostic equipment can malfunction, doctors can’t be scheduled, and patients might get rerouted.

The negative impact of healthcare operations downtime is measured in several ways.

1. Financial

The costs of restoring service when attacks interrupt operations include repairing or replacing capital equipment, as well as bringing on outside experts to help with the restoration.

The theft of PHI or PII can lead to legal actions brought by patients, vendors, business partners, or other parties whose data is compromised.

3. Regulatory

Healthcare is a highly regulated industry around the world. Regulatory bodies have guidelines that carry steep penalties in the event of data loss, patient privacy compromise, or unavailability of critical care.

4. Brand reputation

If a medical facility or doctor’s practice suffers a service interruption due to a cyberattack, patients and others affected surely will share their negative experiences with others.

Research indicates that the average cost of a healthcare data breach now exceeds $10 million, a figure that has climbed steadily from year to year.

How to Ensure Business Continuity in Healthcare

Ensuring that healthcare delivery organizations take every reasonable step to protect their business and medical operations starts with an executive commitment to devoting the right financial, personnel, and technological resources to cybersecurity. Several key steps follow.

1. Identify Risks and Assess Impacts

It’s vital for healthcare organizations — regardless of their size or organizational complexity — to take the time to identify all risks that could trigger a cyberattack and result in a business interruption. Technologies, processes, and people all are potential points of failure, and the impact of a breakdown in any of those areas should be calculated to determine how decision-makers should allocate their time, personnel, and budget.

Bringing in an experienced, independent third party such as a cybersecurity technology partner or consultant to evaluate risks and assess the potential for business disruption can be practical. Often, a third party can objectively assess not only technical risks but also organizational preparedness to deal with those risks to business continuity.

2. Protect Your Data

Having strong network security for both on-premises infrastructure and cloud services is where it all starts. Solutions such as next-generation firewalls, malware protection, IoMT security, data loss prevention, and cloud security are essential parts of a comprehensive cybersecurity plan for healthcare organizations.

Security automation is another key aspect of data protection in healthcare since hospital resources are often stretched thin. With automation, IT and SOC teams can automate their incident response and eliminate a large number of manual alerts every day. This allows security staff to focus on much larger projects in the organization.

3. Add Backup Solutions

Because of the critical nature of PII and PHI, as well as the necessity to keep critical infrastructure up and running, backup systems should be planned, installed, and periodically tested. This includes data protection software, on-premises infrastructure for failover, and off-site backup facilities — either in a remote location or in the cloud.

Be sure to speak with your cloud service provider about how their own backup and failover systems work in case your cloud services are interrupted.

A key requirement in today’s healthcare landscape is to ensure that backup systems, failover plans, and steps to ensure full operations in the event of an unplanned outage is having automated systems in place. But simply making sure that backup generators fire up or that essential workloads move from one cloud platform to another one is only part of the solution.

It must start with having a detailed, flexible plan in place so the automated steps consider when, where, and how to make services immediately available without compromising patient safety or business operations. That plan must be worked out with all parts of the organization: IT, cybersecurity, administration, medical teams, legal, compliance, financial, and operations.

Having all stakeholders actively participate in and contribute to the business continuity plan makes for a more successful effort in the long run. It also is essential that the plan be tested at regular intervals to make sure everyone knows their role and that backup systems and services actually kick in as expected and needed. Ultimately, this thoughtful, inclusive approach will save money, avoid regulatory and legal problems, and — most importantly — ensure the highest possible patient care.

Learn about how Palo Alto Networks is the cybersecurity leader of choice for hospitals and health systems around the world. Visit www.paloaltonetworks.com/healthcare .

How do cybersecurity tools impact business continuity in healthcare?

What cybersecurity solution is best for business continuity in healthcare, is security automation possible for business continuity.

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Best practices for disaster recovery and business continuity in the healthcare sector

Disaster recovery and business continuity are important considerations for all sectors, but become top priorities within the healthcare sector, where patient welfare is reliant on system availability. In this article, we review the unique challenges and requirements within the sector, and best practices and considerations for disaster recovery and business continuity strategies, including utilizing hot DR sites, network monitoring, and cybersecurity.

Understanding healthcare-specific risks and challenges

Disasters which could impact the sector are wide-ranging, from natural disasters compromising a physical server site, to power outages, and malicious attacks such as ransomware.

There are distinctive risks from these potential disasters to the sector specifically, including patient data privacy concerns and regulatory compliance. The data stored and processed by healthcare organisations is particularly sensitive, with patient records including identifiable personal information and medical details. Regulations for the sector vary worldwide, including HIPAA compliance in the U.S. and GDPR compliance in the UK and EU, with significant legal consequences to any breach. The loss of vital records could directly impact the patient, whether it is concerning medication, diagnosis or treatment. Worryingly, a study from Acuserve found that only 17% of healthcare executives have high confidence in their IT team’s ability to recover lost data.

Another major concern is the potential impact of any downtime on patient care. In a hospital, for example, systems are used to monitor patient information and transmit data between practitioners and locations. If these systems were to go down, even for a short time, this would prevent care and treatment of the patients, potentially even leading to patient deaths. It is vital in these high-risk environments that downtime is not just minimized, but eliminated altogether. 

Cyberattacks, particularly ransomware, are a constant concern for the healthcare sector. A report ‘The State of Ransomware in Healthcare 2022’ showed concerning figures, with ransomware attacks doubling from 2020 to 2021, and the sector showing long recovery times after a ransomware attack –  44% took up to a week to recover from the most significant attack, and 25% took up to one month.

A recent example of the impact of a disaster on a healthcare organisation was the ransomware attack on hospital chain CommonSpirit Health in the U.S. in October 2022, which cost the organisation US$160 million . The attack forced CommonSpirit Health to take its systems offline, which impacted more than 100 of their facilities across the U.S. In addition to these costs, the company has faced two class action lawsuits relating to the attack, which alleged that CommonSpirit failed to implement appropriate cybersecurity measures. 

Taking into account the gravity of the risks to the healthcare sector, which in the worst-case scenario could include loss of patient lives, it is clear that disaster recovery and business continuity should be top priority to these organisations. 

What is the best disaster recovery plan for the healthcare sector?

At its core, the best disaster recovery plan for the healthcare sector will consist of processes and procedures that allow organisations to continue operations in the event of a disaster, and ensure they can resume business as usual as quickly as possible. 

For the healthcare sector, where no downtime can be tolerated, and compliance requirements are rigorous, hot disaster recovery (hot DR) is the best solution. Hot DR is designed to operate seamlessly during a disaster by offering a replicated site equipped with all the necessary hardware, software, and applications. Hot DR gives the lowest possible recovery time objective (RTO) – the amount of time taken to recover from a disaster.

Hot DR includes real time replication to optimize your recovery point objective (RPO), with continuous back-ups to a secure secondary site. The RPO is the point in the server’s timeline that you can return to after a disaster, for example with daily back-ups, your maximum RPO would be 24 hours. With continuous replication, your RPO is as low as possible, keeping data loss to an absolute minimum.

Maintaining your own off-site DR environment is tricky for a healthcare organisation that does not necessarily have the in-house expertise or resources to set up or maintain this. Opting to use a provider that offers Disaster Recovery as a Service (DRaaS) for your hot DR solution outsources this requirement, giving you the peace of mind that in the case of a disaster, your site will failover to a certified and compliant secondary DR site. When outsourcing your infrastructure, ensure you are working with a reputable provider, with the relevant accreditations and compliance procedures in place to protect your sensitive data.

Infrastructure considerations for business continuity

While having a robust DR strategy is vital in the case of a disaster, minimizing the risk of a disaster in the first place should be central to your business continuity planning. There are several considerations for your healthcare organisation, including quality of hardware and software, security, and monitoring and management of your infrastructure.

Quality of hardware and software

The quality of hardware and software used in your environment has a significant impact on performance. The technology involved in hosting is constantly developing – your provider should invest in best-of-breed hosting architecture, ensuring top reliability, scalability and performance. Top-of-the-line platforms offer high performance and uptime guarantees, keeping your systems running in the most optimal way. Your provider should also periodically update and audit hardware and software to ensure ongoing reliability. 

Healthcare organisations may face financial constraints which may be an obstacle when investing in the best infrastructure, however this is an instance in which cost should be considered holistically rather than in isolation. With investment in top hardware and software preventing downtime, slow performance and disasters, this can save you the potential costs arising from issues with lower quality infrastructure. Additionally, when you host your platforms with a provider, rather than buying your own hardware for an on-premise solution, the upfront costs are taken away from you, giving you the benefits in performance, while optimizing costs.

A multi-layered approach to security will support you to protect your business against attacks, threats and vulnerabilities, while ensuring that you are meeting the necessary compliance requirements. This approach can include elements such as firewalls, multi-factor authentication, data encryption, intrusion protection and intrusion defense systems, and more. To maintain these security measures, ensure you are completing regular testing to identify any vulnerabilities in your systems so these can be repaired.

Keeping on top of cybersecurity best practice will protect your infrastructure, so to support your approach, you should ensure all staff using your systems undergo a detailed induction and ongoing security training. 

Monitoring and management of infrastructure

In order for your DR plan to be implemented and your systems failover to your secondary site in the event of a disaster, your network will need to be monitored. Tracking and analyzing network performance in real time means any issues will be picked up immediately, and any subsequent measures taken. Often, the quicker an issue is picked up, the quicker and easier it will be to resolve. Effective monitoring can also identify potential issues before they reach the stage where your DR will be required, further reducing their impact. This monitoring can be effectively implemented by a managed service provider (MSP). 

An MSP can provide support and peace of mind for organisations in the healthcare sector, expertly managing your infrastructure and allowing you to concentrate on running your business. Managed hosting can include all of the measures mentioned so far – disaster recovery planning, infrastructure design, security, and network monitoring. With these elements all taken out of your hands, you can be assured that your systems are running safely and effectively.

The risks present to the healthcare sector are evolving, particularly when it comes to cybersecurity, which means that best practices in infrastructure are also evolving. In a constantly busy organisation, it can be difficult to keep up with the landscape and know how to best protect yourself. Leveraging the expertise of an MSP who is up to date with the latest developments means your business can continue to be protected throughout this development. 

Work with Hyve to build the best DR solution for your healthcare organisation

We have 20 years of experience supporting health and social care institutions through our fully managed hosting solutions. Our experts work with you to design a resilient, secure platform, with comprehensive DR and business continuity strategies in place.

Find full details of the DR solutions offered by Hyve on our disaster recovery page . For more information on our hosting solutions, visit our hosting for healthcare page.

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An “All Hazards” Approach to Business Continuity Planning Is Healthcare’s Next Challenge

One of the most important lessons healthcare companies learned during the COVID-19 pandemic is that they need to implement and maintain better strategies, processes and procedures to enable resiliency and recovery. As they seek to mature their business continuity plans (BCPs)/continuity of operations plans (COOPs), not only to satisfy recently increased regulatory scrutiny by the Centers for Medicaid and Medicare Services (CMS) and The Joint Commission (TJC) on recovery documentation but also to be better prepared for the next event, organizations are realizing that many of the existing plans focus on information technology disruptions and events, and not so much on other important aspects of business continuity, such as identifying vulnerabilities, developing supply chain resiliency plans or after-action reporting. However, regulatory bodies have emphasized an “all hazards” approach to business continuity, which is necessary for effective response and recovery. In this blog, we outline the necessary steps to developing a robust BCP/COOP that addresses that emphasis.

Cornerstones of an Effective Business Continuity Plan

BCPs/COOPs are crucial to healthcare organizations to help them remain both fiscally viable and operational in order to provide care for the community during and after an emergency. The BCP reduces economic impact to the organization during an event, allowing it to maintain critical business and logistical functions. Further, BCPs help healthcare organizations recover and get back to business as usual more quickly and effectively. During an event such as the COVID-19 pandemic, healthcare organizations would activate both their required emergency preparedness plans and their BCPs or COOPs.

Effective business continuity planning starts with a business continuity team that can tackle the plan development in phases. Every BCP starts with a hazard vulnerability analysis (HVA). The HVA assesses the level of risk, preparedness and impact on an individual healthcare organization of hazards of any kind, including natural disasters, infrastructure failures, security threats, mass casualty events and, now, infectious diseases (e.g., Ebola, Zika and COVID-19).

The HVA is complemented by a business impact analysis (BIA) an organization’s essential processes and what would happen if each of these processes is disrupted. The BIA is performed at a department level and incorporates all regulatory and legal requirements for each of the processes. One output of the BIA is the establishment of a recovery timeline, which indicates how long a function or service can be down, and a recovery point, which specifies the acceptable amount of data that can be lost for each specified function. Healthcare organizations should identify and prioritize these essential services at a departmental level in the context of the organization’s top-ten HVA risk categories. It is helpful to establish a strategy for the prioritization of essential processes and functions, such as a numeric scoring matrix. For example:

• Priority 1:  Functions that could pose an immediate threat to employee or patient safety and welfare and/or have an immediate negative economic impact if not continually performed.
• Priority 2:  Functions that, if stopped or delayed, would cause a major negative impact to the healthcare organization and stakeholders. This includes services that may impact contractual obligations with internal or external parties, such as patients, employees or vendors.
• Priority 3:  Functions that that would cause a minor negative impact if suspended or delayed, including services required by contractual obligations with vendors, employees or patients.

After identifying and prioritizing processes and functions, organizations need to determine the resources necessary to carry out each service. This should include memorandums of understanding (MOUs) with all partners, third parties and suppliers essential to carrying out the prioritized functions. Teams need to think broadly when compiling the list of required resources: They should include physical equipment, IT applications, interdependencies, and any special skills required to perform the essential functions. Identifying all personnel trained and qualified to perform a particular essential service can help reallocate resources more easily. To this end, an organizational matrix that details the skill sets required for all essential roles will ensure that those skills remain top of mind. Further, maintaining a record of employee-related information such as licenses, certifications and completed training will allow healthcare organizations to fill essential roles and facilitate mobilization of workers within the organization as needs arise.

After-Action Reporting

After-action reporting is an important component of business continuity management. It is the deliberate utilization of the organization’s after-action reporting process not only to gather feedback after an event but to summarize what took place, analyze the actions taken by participants and highlight areas needing improvement. Further, an after-action report enables organizations to track compliance and, most importantly, provides input for updating the BCP/COOP (and emergency operations plans), which should be updated annually or after any significant event. Based on the after-action reports, MOUs with community partners should also be updated.

The following are additional best practice considerations for emergency management recovery processes:

• Issue regular and transparent communications that reassure employees and balance caution with a business-as-usual mindset.
• Utilize MOUs with community, state and local authorities and vendors.
• Implement a supply chain resiliency strategy and keep in contact with suppliers regarding their ability to perform their contractual obligations, or reset business assumptions and update memorandums of understanding, as necessary.
• Monitor state and federal support initiatives while remaining mindful of documentation requirements.
• Determine how the event affects budgets and business plans to assess financial and operational risks, including the evaluation of short-term liquidity (e.g., terms and conditions on loans and contracts with creditors and investors).
• Consult legal teams for advice on potential liabilities and risk mitigation.
• Review, test and update as needed business continuity plans by department or service.

As healthcare organizations return to a “new normal,” they are continually attempting to determine what their pathway to recovery will look like. Do we have enough supplies for patients and staff? What will our financials look like? Is our crisis response working? Are we compliant with TJC and CMS requirements? These are questions that organizations are asking themselves as they go through this unprecedented time. As discussed, the following key components should mark the path to recovery and help healthcare organizations mature their emergency response programs:

• Organizational risk assessment/hazard vulnerability analysis: study of potential operational risks and their likelihood. There should be an understanding internally of workarounds/contingent capabilities to mitigate the impact of those risks if they were to occur.
• Business impact analysis: A study, by department, of all business processes within an organization that incorporates all the regulatory and legal requirements for each of the processes. Further, a business impact analysis report should be created as part of the overall analysis that outlines the findings, the most critical processes, and the equipment, tools, staff and timelines required to ensure that these processes remain active during a disruption or become active as soon as possible after a disruption.
• Business continuity plan or continuity of operations plan:  A robust BCP or COOP that addresses the critical processes necessary for the organization to continue services. This plan is updated through an supported by senior management. BCPs/COOPs should be developed, implemented and maintained by a multidisciplinary team that represents various departments and key stakeholders who will be tasked with identifying and prioritizing those critical processes that should be maintained during and after an incident. The BCP highlights the organization’s commitment to the continuity of business services during and after an incident and its commitment to plan maintenance, training and drills. All aspects of a BCM program should be tested regularly, preferably in an integrated fashion that allows for validation of interdependent recovery strategies, plans and teams.

Applying these best practices ensures the controlled, efficient, and cost-effective release of resources and mitigates healthcare organizations’ fiscal, legal and regulatory risks. For more on the topic, listen to our on-demand webinar “Healthcare Emergency Management Insights, Including Resilience Considerations: Turning Pandemic Learnings Into More Effective Emergency Management Initiatives.”

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Healthcare Business Continuity Plan Template

What is a Healthcare Business Continuity Plan?

A healthcare business continuity plan outlines the steps needed to ensure that patient care, healthcare services, and medical operations are continued during times of emergency or unforeseen circumstances. This plan includes strategies to address potential risks, as well as strategies to maintain critical operations such as communication systems, medical equipment maintenance, and patient triage protocols. This plan is important for healthcare organizations, hospitals, and medical facilities to be prepared for any potential disruption.

What's included in this Healthcare Business Continuity Plan template?

• 3 focus areas
• 6 objectives

Each focus area has its own objectives, projects, and KPIs to ensure that the strategy is comprehensive and effective.

Who is the Healthcare Business Continuity Plan template for?

This template is for healthcare organizations, hospitals, and medical facilities who are looking for an organized and comprehensive way to develop their business continuity plans. The template is designed to help healthcare organizations define their focus areas, objectives, projects, and measurable targets (KPIs) to ensure continuity of patient care, healthcare services, and medical operations during unexpected events.

1. Define clear examples of your focus areas

A focus area is a broad topic or field that you want to address when developing your business continuity plan. Examples of focus areas you may want to consider include ensuring continuity of patient care, continuity of healthcare services, and continuity of medical operations. By defining specific focus areas, you can isolate the objectives, projects, and KPIs that need to be implemented to ensure the continuity of each area.

2. Think about the objectives that could fall under that focus area

An objective is a goal that you want to achieve under a specific focus area. For example, if your focus area is ensuring continuity of patient care, your objectives could include establishing emergency response/restoration teams, improving communication systems, and other related actions. Objectives should be specific and achievable within a reasonable timeframe.

3. Set measurable targets (KPIs) to tackle the objective

A KPI, or key performance indicator, is a measurable target that will help you track the progress of your objectives. KPIs should be outlined in the form of a measure, initial value, target value, and unit. For example, “Decrease patient triage time from 5 minutes to 1 minute” is a KPI that includes a measure (decrease patient triage time), initial value (5 minutes), target value (1 minute), and unit (minutes).

4. Implement related projects to achieve the KPIs

A project, or action, is an initiative that you will take to achieve your KPIs. For example, if your KPI is to “Decrease patient triage time from 5 minutes to 1 minute”, your project may be to create patient triage protocols. By implementing related projects to achieve your KPIs, you can ensure that you take the necessary steps to reach your objectives.

5. Utilize Cascade Strategy Execution Platform to see faster results from your strategy

Cascade Strategy Execution Platform is designed to help healthcare organizations develop and track their business continuity plans. With Cascade, you can easily organize your focus areas, objectives, projects, and KPIs in one place, and track the progress of each to ensure that your plan is on track. You can also work with your team to collaborate and share feedback in real-time, making it easier to adjust and improve your strategy.

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• Business Continuity

Protect Patient Care and Privacy with Healthcare Business Continuity Planning

Dale Shulmistra

• February 24, 2023

Maintaining continuity is vital for every business, but perhaps no other industry faces the same level of urgency as healthcare. Without a solid healthcare business continuity plan in place, healthcare organizations could become paralyzed by a crisis at any time. This poses a risk not only to the organization’s bottom line but also to the privacy and safety of patients and staff.

Healthcare facilities, including hospitals, clinics, and labs, play a critical role in public health, which puts them in an especially precarious position when it comes to continuity. If a hospital’s IT network fails, it can endanger the facility’s reputation and financial standing, not to mention patient health. Read on to learn what risks today’s healthcare organizations face and how an established system of business continuity can better prepare them for any emergency scenario on the horizon.

The Importance of Healthcare Business Continuity

While the principles of business continuity are generally the same regardless of industry, healthcare business continuity stands apart in several ways. When a healthcare facility experiences data loss or other disasters, the downtime affects more than just the “business.” It also affects:

• Patients:  If a facility experiences an emergency and hasn’t planned properly, patient care might be disrupted or delayed, which can have serious long-term effects.
• Patient data:  Cyberattacks and data breaches can expose sensitive health and identifying information to unauthorized parties, creating the risk of identity theft.
• Legal liabilities: If a loss in care puts patients’ health at risk, the facility may face accusations of negligence.
• Regulatory liabilities: Facilities that are found to be noncompliant with federal laws like the Health Insurance Portability and Accountability Act (HIPAA) can be hit with huge fines—on top of all the other losses caused by the disruption.

The importance of healthcare business continuity planning cannot be overstated. Every facility—whether it’s a small town doctor’s office or a  sprawling regional hospital system —must have a comprehensive plan for disaster prevention and recovery.

Possible Continuity Disruptions for Healthcare Organizations

Healthcare facilities face a wide range of risks that can interrupt operations, take critical systems offline, and limit the ability to care for patients. When developing a business continuity strategy, it’s important to consider all potential disruptions, including:

• Natural disasters such as earthquakes, hurricanes, and fires
• Power and water outages
• Widespread staff illnesses
• Supply chain disruptions
• Cyberattacks, including data loss from malware and ransomware

While a single organization is unlikely to experience multiple emergencies on a regular basis, evaluating each type of threat and how it would affect your facility is an essential step. Knowing the risks you face empowers you to adequately prepare, which, in turn, shortens recovery times and significantly reduces financial losses.

The Threat of Ransomware in Healthcare

While hospitals and other healthcare providers face a variety of threats, ransomware has become particularly ominous. In recent years, the Cybersecurity and Infrastructure Security Agency (CISA), in partnership with the Federal Bureau of Investigation (FBI) and the Department of Health and Human Services (DHHS), has issued dire warnings and advisories about the risk of ransomware attacks against the healthcare industry. Let’s dig into the details of how ransomware affects healthcare business continuity.

Frequency and Severity

Healthcare organizations are under regular siege by cyberattackers, and the situation has grown progressively worse over time. Data breaches on the whole have been on an upward trajectory for several years, particularly in cases involving large quantities of patient information. The number of healthcare data breaches involving 500 or more patient records steadily increased from 2009 to 2021 .

While data breaches occur due to a variety of errors and attacks, ransomware is the most concerning cause, and more healthcare organizations are experiencing ransomware attacks than ever before. A 2022 report from Sophos revealed that 66% of surveyed healthcare organizations  surveyed experienced a ransomware attack in 2021, compared to 34% in 2020.

Ransomware is not only becoming more frequent but also more serious. These worrying statistics  from a recent study published by the Journal of the American Medical Association further demonstrate the gravity of the ransomware threat against healthcare organizations:

• The annual number of ransomware attacks on US healthcare organizations doubled from 2016 to 2021.
• In that five-year period, 374 ransomware attacks on US healthcare organizations exposed the personal health information (PHI) of approximately 42 million patients.
• Nearly half of the ransomware attacks in the healthcare industry disrupted the delivery of care.
• Among organizations that experienced an attack, 41.7% suffered electronic system downtime and 10.2% had to cancel scheduled care.

These statistics underscore the importance of healthcare business continuity planning, which integrates prevention and recovery strategies that can reduce the likelihood that a ransomware attack will occur and minimize the damage if it does.

Consequences

Reports of ransomware incidents often focus on the immediate effects like system outages, but the consequences are much more complex than an initial assessment of the situation might suggest. Additional details from the Sophos survey paint a clear picture of how a ransomware attack might impact a healthcare facility:

• Healthcare organizations are far more likely to pay ransom demands to restore their encrypted data, yet they recover far less data. In 2021, healthcare organizations recovered 65% of their data, on average, after paying the ransom.
• Recovery times for ransomware attacks against healthcare are painfully lengthy, with one in four organizations needing up to a month to recover.
• Among surveyed healthcare organizations, 94% stated that the attack caused business or revenue losses, with an average remediation cost of $1.85 million.

Despite these potentially devastating outcomes, healthcare organizations have not adequately invested in measures like cyber insurance, particularly in comparison to other industries. This lack of preparation puts life-saving facilities in incredibly vulnerable positions.

The CommonSpirit Attack

While statistics are a useful means of understanding the ransomware threat, a real-life example helps put everything in context. The attack against CommonSpirit Health perfectly captures the danger posed by ransomware.

In early October 2022, CommonSpirit, the second-largest nonprofit hospital chain in the United States, identified a ransomware attack against its systems. Though the organization says it acted quickly to prevent extensive damage, the effects speak for themselves:

• Many of CommonSpirit’s hospitals had to cancel appointments and take patient portals and electronic health records offline.
• Annual financial records revealed that the cost of the outage was approximately $150 million.
• The attack exposed the personal health and personal identifying information of more than 600,000 patients .

Following the disclosure that patient information was exposed, CommonSpirit has faced multiple class-action lawsuits on behalf of plaintiffs who argue that the organization didn’t take adequate steps to protect sensitive data. One lawsuit is seeking more than $5 million in damages, while another is requesting complimentary credit monitoring services, actual damages, compensatory damages, statutory damages, and statutory penalties. If the court rules against CommonSpirit, these suits could cost the organization millions, in addition to the recovery and revenue losses they experienced during the initial attack. The ransomware attack on CommonSpirit is a prime example of how such incidents can cause not only an immediate disruption but also a long-term impact on patient trust.

Why Ransomware Targets Healthcare Facilities

With such a variety of businesses available to target, why do ransomware gangs continue to focus on hospitals and healthcare? One reason is that many organizations implement woefully inadequate cybersecurity measures despite the imminent threat of a cyberattack . The most common vulnerabilities include:

• Lack of system patching: Organizations often have lax protocols for updating applications and operating systems.
• Not enough cybersecurity training: Healthcare workers, including physicians, often fall prey to malicious emails containing malware or links to infected sites, and they don’t receive enough training in recognizing the signs of a phishing scam.
• Weak passwords : Lax password-management policies at healthcare facilities make it easy for hackers to break into otherwise secure applications.
• Unprotected devices : Today’s advanced medical devices are increasingly connected to the Internet, but they often aren’t protected with the same cybersecurity measures as traditional hardware.
• Outdated data backup systems : Healthcare groups have been slow to upgrade to more advanced data backup solutions that could help them minimize the risk of data loss after an attack like ransomware.

Hackers are well aware of cybersecurity weaknesses in the healthcare industry, and they’re happy to exploit them for personal financial gain. They also know that patient data is voluminous and highly sensitive, which increases the likelihood that healthcare facilities will pay the ransom. Maintaining business continuity in healthcare will remain a challenge until these vulnerabilities are resolved across the industry.

How Healthcare Business Continuity Literally Saves Lives

The CommonSpirit ransomware attack provided a clear illustration of how a disruption can be detrimental to patients: records were completely lost, and patients were effectively forgotten by their providers.

Consider also the attack on the Health Service Executive (HSE), the national healthcare system in Ireland. A ransomware attack rendered many of the healthcare facilities within the system unable to provide patient care, leading to canceled appointments for services like cancer treatments. A similar, smaller-scale incident occurred at Tallahassee Memorial HealthCare, one of the largest hospitals in the south. Tallahassee Memorial had to cancel appointments and divert ambulances to other hospitals due to a cyberattack in February 2023. While canceled appointments may seem like a nuisance, for many patients, they can mean a delay in critical care and worse long-term outcomes.

The effects also go beyond appointment cancelations. Imagine the effects of lost data, such as patient records, in intensive care units. A disruption in medication delivery or confusion about a patient’s existing conditions can create life-threatening situations. Make no mistake: a break in healthcare continuity is a break in patient care, and facilities have an obligation to create an effective continuity strategy.

The Sky-High Costs of Downtime in Healthcare

An operational disruption can be expensive for any business. For smaller companies, a single hour can easily cost more than $10,000. But for large healthcare organizations, those downtime costs can balloon into millions of dollars per hour.

Running a healthcare facility is naturally expensive. Under normal circumstances, those costs are offset by the healthcare costs passed onto patients and their insurance providers. Unfortunately, when a disaster causes 19,000 appointments to be canceled, for example, that’s a huge loss in revenue—especially when salaried health professionals are still being paid despite the disruption. Patient care aside, these sky-high costs are another reason why healthcare organizations are under more pressure to maintain continuity.

The Risk of Regulatory Noncompliance

Federal regulations are especially strict for healthcare organizations, and rightly so. A failure in healthcare business continuity planning can not only put patients at risk of bodily harm but also their most sensitive data to cybercriminals. To help prevent these risks, the U.S. government developed regulations like HIPAA. The law sets specific rules for how healthcare organizations handle sensitive data, including:

• Transmission and processing
• Protections against theft and instruction
• Back-up methods

Under the law’s Security Rule , a healthcare organization must deploy technology and protocols that enable it to quickly restore data after a disruptive event so that it can continue operating in “emergency mode.” A failure to comply with HIPAA comes with steep costs, with each violation carrying a fine of up to $50,000 . As such, every healthcare organization should have a  HIPAA compliant disaster recovery plan.

Key Steps to Healthcare Business Continuity

When developing continuity plans, healthcare organizations must keep some essential steps in mind. Identifying risks, evaluating impacts, and implementing better backup solutions creates a foundation for better continuity.

Identify Risks and Impacts

The first step to setting any business continuity objective at a healthcare organization is creating a comprehensive disaster recovery plan (DRP), which should include two core components: risk assessment and business impact analysis.

Healthcare organizations must assess all the risks that pose a threat to operations, including data breaches, ransomware attacks, and hardware failures. It’s important to evaluate each organization individually as location, size, and structure can play a significant role in determining whether a threat exists and how severe it might be.

Following a risk assessment, every hospital facility should conduct a business impact analysis to determine how each type of event would hurt operations. Important questions to ask include:

• How long would recovery take?
• What costs would accrue?
• What services might be disrupted?

An impact analysis reveals just how bad things could get, thus helping an organization understand which solutions are needed to mitigate and recover from such events.

Establish Stronger Data Protection

Data threats like ransomware aren’t going away anytime soon, especially while healthcare organizations continue to leave themselves exposed to targeted attacks. However, high-quality backup solutions significantly reduce the risk of data loss and downtime, even after a large-scale ransomware attack. Large facilities can make use of  data backups with ransomware detection and massive storage capacities. Small practices and community clinics, on the other hand, can benefit from more affordable options with smaller capacities but equivalent security features.

Backup frequency and storage type are also important considerations. With the ability to schedule backups as often as every five minutes and recover a virtualized backup in seconds, healthcare firms can maintain continuity through nearly any data disruption. Hybrid backups , which store data both on-site and in the cloud, make it more likely that organizations can recover data even after an aggressive attack. This kind of protection is needed throughout the healthcare industry to ensure operational continuity, no matter what form of data disaster strikes next.

The Essentials of IT Disaster Recovery for Healthcare

All components of a healthcare organization’s IT infrastructure must be adequately protected against downtime threats. Similarly, when any of those systems are disrupted, the organization must have a solution in place that enables a rapid recovery. Essential components for disaster recovery in healthcare include:

• Network security and redundancy
• Data backup solutions
• Antimalware systems
• Redundant telecommunications lines
• Backup power generators

However, recovery alone is not enough. Prevention is also crucial to business continuity. Among the most important preventative measures are:

• Cybersecurity training for personnel
• Disaster recovery testing and drills
• Network penetration tests
• Test recoveries of data backups

Failure to employ any one of these strategies could leave healthcare organizations unprepared to cope with potential crises and disasters.

Where to Turn for Better Healthcare Business Continuity

Healthcare business continuity is a matter of financial stability, organizational longevity, and patient safety, but it often feels like an overwhelming and burdensome process. Healthcare organizations that don’t yet have a business continuity or disaster recovery plan in place can begin with a template that they can tailor to align with the needs of their individual facilities.

If your healthcare organization needs some extra help preparing for possible disasters, make use of the resources available through Invenio IT. To see firsthand how a business continuity solution can protect your healthcare organization against ransomware and other data threats, request a free demo  of today’s advanced technology. For guidance on how to develop a stronger healthcare business continuity plan, reach out to Invenio IT’s team of disaster recovery experts.

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• Business Continuity Plan Basics
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The Bottom Line

What is a business continuity plan (bcp), and how does it work.

Investopedia / Ryan Oakley

What Is a Business Continuity Plan (BCP)? 

A business continuity plan (BCP) is a system of prevention and recovery from potential threats to a company. The plan ensures that personnel and assets are protected and are able to function quickly in the event of a disaster.

Key Takeaways

• Business continuity plans (BCPs) are prevention and recovery systems for potential threats, such as natural disasters or cyber-attacks.
• BCP is designed to protect personnel and assets and make sure they can function quickly when disaster strikes.
• BCPs should be tested to ensure there are no weaknesses, which can be identified and corrected.

Understanding Business Continuity Plans (BCPs)

BCP involves defining any and all risks that can affect the company's operations, making it an important part of the organization's risk management strategy. Risks may include natural disasters—fire, flood, or weather-related events—and cyber-attacks . Once the risks are identified, the plan should also include:

• Determining how those risks will affect operations
• Implementing safeguards and procedures to mitigate the risks
• Testing procedures to ensure they work
• Reviewing the process to make sure that it is up to date

BCPs are an important part of any business. Threats and disruptions mean a loss of revenue and higher costs, which leads to a drop in profitability. And businesses can't rely on insurance alone because it doesn't cover all the costs and the customers who move to the competition. It is generally conceived in advance and involves input from key stakeholders and personnel.

Business impact analysis, recovery, organization, and training are all steps corporations need to follow when creating a Business Continuity Plan.

Benefits of a Business Continuity Plan

Businesses are prone to a host of disasters that vary in degree from minor to catastrophic. Business continuity planning is typically meant to help a company continue operating in the event of major disasters such as fires. BCPs are different from a disaster recovery plan, which focuses on the recovery of a company's information technology system after a crisis.

Consider a finance company based in a major city. It may put a BCP in place by taking steps including backing up its computer and client files offsite. If something were to happen to the company's corporate office, its satellite offices would still have access to important information.

An important point to note is that BCP may not be as effective if a large portion of the population is affected, as in the case of a disease outbreak. Nonetheless, BCPs can improve risk management—preventing disruptions from spreading. They can also help mitigate downtime of networks or technology, saving the company money.

How To Create a Business Continuity Plan

There are several steps many companies must follow to develop a solid BCP. They include:

• Business Impact Analysis : Here, the business will identify functions and related resources that are time-sensitive. (More on this below.)
• Recovery : In this portion, the business must identify and implement steps to recover critical business functions.
• Organization : A continuity team must be created. This team will devise a plan to manage the disruption.
• Training : The continuity team must be trained and tested. Members of the team should also complete exercises that go over the plan and strategies.

Companies may also find it useful to come up with a checklist that includes key details such as emergency contact information, a list of resources the continuity team may need, where backup data and other required information are housed or stored, and other important personnel.

Along with testing the continuity team, the company should also test the BCP itself. It should be tested several times to ensure it can be applied to many different risk scenarios . This will help identify any weaknesses in the plan which can then be corrected.

In order for a business continuity plan to be successful, all employees—even those who aren't on the continuity team—must be aware of the plan.

Business Continuity Impact Analysis

An important part of developing a BCP is a business continuity impact analysis. It identifies the effects of disruption of business functions and processes. It also uses the information to make decisions about recovery priorities and strategies.

FEMA provides an operational and financial impact worksheet to help run a business continuity analysis. The worksheet should be completed by business function and process managers who are well acquainted with the business. These worksheets will summarize the following:

• The impacts—both financial and operational—that stem from the loss of individual business functions and process
• Identifying when the loss of a function or process would result in the identified business impacts

Completing the analysis can help companies identify and prioritize the processes that have the most impact on the business's financial and operational functions. The point at which they must be recovered is generally known as the “recovery time objective.”

Business Continuity Plan vs. Disaster Recovery Plan

BCPs and disaster recovery plans are similar in nature, the latter focuses on technology and information technology (IT) infrastructure. BCPs are more encompassing—focusing on the entire organization, such as customer service and supply chain. 

BCPs focus on reducing overall costs or losses, while disaster recovery plans look only at technology downtimes and related costs. Disaster recovery plans tend to involve only IT personnel—which create and manage the policy. However, BCPs tend to have more personnel trained on the potential processes. 

Why Is Business Continuity Plan (BCP) Important?

Businesses are prone to a host of disasters that vary in degree from minor to catastrophic and business continuity plans (BCPs) are an important part of any business. BCP is typically meant to help a company continue operating in the event of threats and disruptions. This could result in a loss of revenue and higher costs, which leads to a drop in profitability. And businesses can't rely on insurance alone because it doesn't cover all the costs and the customers who move to the competition.

What Should a Business Continuity Plan (BCP) Include?

Business continuity plans involve identifying any and all risks that can affect the company's operations. The plan should also determine how those risks will affect operations and implement safeguards and procedures to mitigate the risks. There should also be testing procedures to ensure these safeguards and procedures work. Finally, there should be a review process to make sure that the plan is up to date.

What Is Business Continuity Impact Analysis?

An important part of developing a BCP is a business continuity impact analysis which identifies the effects of disruption of business functions and processes. It also uses the information to make decisions about recovery priorities and strategies.

FEMA provides an operational and financial impact worksheet to help run a business continuity analysis.

These worksheets summarize the impacts—both financial and operational—that stem from the loss of individual business functions and processes. They also identify when the loss of a function or process would result in the identified business impacts.

Business continuity plans (BCPs) are created to help speed up the recovery of an organization filling a threat or disaster. The plan puts in place mechanisms and functions to allow personnel and assets to minimize company downtime. BCPs cover all organizational risks should a disaster happen, such as flood or fire.  

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Preparing for the Financial Impacts of a Disaster California Hospital Association

To help members plan for and respond to the financial impacts impacts of disasters, the California Hospital Association has prepared this guide outlining considerations for hospitals as they develop a financial preparedness and response plan.

The guide provides an outline of financial challenges hospitals face in preparing for disasters while providing hospitals and healthcare organizations with insights and recommendations on how to enhance their financial resilience in the face of disasters.

This resource also provides an overview of the various aspects of disaster preparedness and response from a financial standpoint, including the costs associated with planning, infrastructure, staffing, and resource allocation.

It also provides hospitals with strategies and best practices to mitigate financial risks, optimize resource management, and strengthen their ability to maintain operations and provide essential healthcare services during emergencies.

Preparing Hospitals for Disasters – A Financial Perspective

Retaining and Caring for Staff after a Disaster ASPR TRACIE

When a disaster strikes, access to services becomes even more critical. And yet hospital staff and emergency services providers can be victims of that same disaster. ASPR TRACIE has released an updated version of its  Tips for Retaining and Caring for Staff after a Disaster to guide facility executives in assisting staff through the recovery period.

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Hospital Business Continuity Templates

These Business Continuity Plan (BCP) templates and instruction manuals are provided by the Los Angeles County Emergency Medical Services (EMS) Agency as a resource to assist healthcare facilities develop their business continuity plans and meet the Hospital Preparedness Program’s Healthcare Preparedness Capability

The Los Angeles County EMS Agency has conducted several business continuity-related webinars and workshops.  These resources, including BIA tools, interviewing tips, and more are available here.

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Continuity 101 Angela Devlen, Wakefield Brunswick, Inc.

This presentation was delivered as part of the pre-conference workshopat the Disaster Planning for California Hospitals Conference.

This portion of the workshop was designed to educate hospitals on establishing and maintaining a continuity program that will allow the continuation of essential clinical, research, business and administrative operations in the event of natural, technological, man-made or public health emergencies.

• Download the presentation: “Continuity 101″

Hospital Continuity Resources A Toolkit for Healthcare Providers

CHA Hospital Continuity Program Checklist

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Business Continuity Planning Toolkit

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VI. Appendixes

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• Download Appendix D1: Technical Documentation for Maintaining Business Continuity Plan Tool  (.doc)
• Download Appendix E: Department Status Forms/Summary (.doc)
• Download Appendix F: Business Continuity Planning PowerPoint to Management  (.ppt)
• Download Appendix G: Utilizing Your Business Continuity Plan  (.ppt)

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Business Continuity Planning Suite DHS National Protection and Programs Directorate / FEMA

This software was created for any business with the need to create, improve, or update its business continuity plan. The Suite is scalable for optimal use by organizations of any size and consists of a business continuity plan (BCP) training, automated BCP and disaster recovery plan (DRP) generators, and a self-directed exercise for testing an implemented BCP. Businesses can utilize this solution to maintain normal operations and provide resilience during a disruption.

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The Stafford Act

The Stafford Act encourages the development of comprehensive disaster preparedness assistance plans, programs and capabilities by State and local governments. It also provides grants and other assistance to state and local governments in the development of preparedness plans and procedures. 

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Business Continuity for Small Hospitals Barbara Dodge, University of Nebraska Medical Center

This workshop was delivered at the Disaster Planning for California Hospitals Conference with a focus on the unique needs and resources of small hospitals as they prepare for, respond to, and continue to offer services after a disaster occurs.

• Download the presentation: “Soup to Nuts, OB to IT, Business Continuity for Small Hospitals″

Continuity of Operations Plan Template California Association of Health Facilities (CAHF)

This template is designed to assist long term care providers in developing an effective continuity of operations (COOP) plan for emergency scenarios.  While this template is designed for long term care, small and rural hospitals may find the template useful and adaptable.

• Download the Continuity of Operations Plan Template

Keeping Business Viable After a Disaster Audio Lecture: Karl Matzke (Stanford Graduate School of Business alumnus and first responder) and FEMA administrator Craig Fugate

Getting businesses, big and small, back into a community and keeping them viable after disaster is an issue that affects the local landscape.

Listen to Karl Matzke, a Stanford Graduate School of Business alumnus and volunteer first responder, as he has a conversation with FEMA administrator Craig Fugate. Prior to FEMA, Fugate also worked in emergency management at the local and state level and brings insight to his role at FEMA.

The audio covers availalble resources for corporations and small to medium-sized businesses to prepare and protect themselves from the impact of disaster. For a community to maintain a healthy recovery, Fugate asserts that private and public groups must work collaboratively to help stabilize an environment after disaster.

• Play the Audio Lecture (mp3)
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Reimbursement for Acute Care Hospitals Guide FEMA

A comprehensive guide outlining the process and requirements for hospitals seeking reimbursement from the Federal Emergency Management Agency (FEMA) through the Alternative Care Site (ACS) program.

This resource provides detailed guidance to hospitals on how to navigate the reimbursement process effectively while maximizing their eligibility for funding related to establishing and operating ACS facilities during emergency situations.

It outlines key eligibility criteria, documentation requirements, and reimbursement procedures, aiming to assist hospitals in understanding FEMA’s reimbursement policies and ensuring compliance with federal regulations.

• Reimbursement for Acute Care Hospitals Guide

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See a summary of all our training options one page. All courses are currently available online.

The leader in business continuity education and certification across many industries, DRI International offers team training designed to fit the needs of every organization, from private corporations to the public sector and everywhere in-between.

DRI International offers colleges and universities the opportunity to familiarize their students with information on business continuity professions and certifications recognized by private and public sector organizations around the world.

• Individual Certification
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• Honor Society
• Center of Excellence in Resilience
• Resilient Enterprise

* DRI's three levels of certification are associate certified, certified and master certified. Certifications beginning with "A" are associate, "C" certified and "M" master.-->

Certification is a two-part process; verification of knowledge and confirmation of experience.

A DRI International certification is the most widely recognized and respected business continuity certification in the world. DRI only certifies professionals that have demonstrated both knowledge and experience in the business continuity and/or disaster recovery profession.

Learn more about how to unlock your DRI digital badge and display your DRI certification to enhance your online professional profile today.

Maintaining your DRI International certification carries two requirements; an annual maintenance fee as well as Continuing Education Activity Points (CEAP).

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Learn more and register for this free online event March 1-3, 2021!

Be a part of the premier business continuity conference. Join us at DRI2025 in Las Vegas, Feb. 2-5, 2025. Check back for more information.

We speak at numerous industry events around the globe and engage with our community in a variety of ways. Find out where you can meet DRI at these upcoming events.

Join us for the must-attend DRI annual conference for business continuity and resilience professionals taking place in Las Vegas, Nevada Feb 17-20, 2019.

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Learn how to hire the right business continuity professionals that will enable your organization to withstand any crisis and come through even stronger with the DRI Hiring Guide. Download now.

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Track: Healthcare Continuity Course Title: Business Continuity for Healthcare Course ID: HCLE 2000 Relevant Certifications (requires additional step): AHPCP , CHPCP Duration: 4 Days (Four full days of instruction 8:30 a.m. – 5:00 p.m.; Examination online at your leisure) 32 Continuing Education Activity Points (CEAPs) may be awarded toward recertification if applicable. The cost of this course includes both the course and the exam. A certificate of completion for the course will only be delivered once the exam is completed and payment has been received. Exam results will then be released. Cost: $2,850.00

Description

1. Define acronyms and terminology in the business continuity industry 2. Recognize the business continuity planning stages and requirements of the Professional Practices for Business Continuity Management as they relate to a healthcare setting 3. Recall the roles for disaster recovery and emergency management professionals as related to the healthcare industry 4. Identify and explain trends in the business continuity field as they apply to a healthcare setting 5. Design effective business continuity/disaster recovery efforts for case studies through the application of knowledge gained in this class 6. Identify the disaster recovery regulations and standards specific to the healthcare industry 7. Prepare for the Healthcare Examination which requires a minimum passing grade of 75%

Lesson 1: Program Initiation and Management - Establish the need for a business continuity program - Obtain support and funding for the business continuity program - Coordinate and manage the implementation of the business continuity program throughout the entity Lesson 2: Risk Assessment - Identify risks that can adversely affect an entity’s resources or image - Assess risks to determine the potential impacts to the entity, enabling the entity to determine the most effective use of resources to reduce these potential impacts Lesson 3: Business Impact Analysis - Identify and prioritize the entity’s functions and processes in order to ascertain which ones will have the greatest impact should they not be available - Assess the resources required to support the business impact analysis process - Analyze the findings to ascertain any gaps between the entity’s requirements and its ability to deliver those requirements Lesson 4: Developing Business Continuity Strategies - Develop a program that effectively integrates business continuity, emergency operations and disaster recovery requirements - Identify regulatory requirements - Align strategies that comply with regulatory requirements - Apply the business impact analysis (BIA) and risk evaluation to develop effective business continuity strategies - Apply your knowledge to successfully complete the classroom exercise at the end of this lesson Lesson 5: Incident Response - Develop and assist with the implementation of an incident management system that defines organizational roles, lines of authority and succession of authority - Define requirements to develop and implement the entity’s incident response plan - Ensure that incident response is coordinated with outside organizations in a timely and effective manner when appropriate Lesson 6: Business Continuity Plan Development and Implementation - Identify the business continuity plan requirements - Recognize the requirements necessary to design, develop and publish the business continuity plan - Apply your knowledge to successfully complete the classroom exercise at the end of this lesson Lesson 7: Awareness and Training Programs - Establish and maintain training and awareness programs that result in personnel being able to respond to incidents in a calm and efficient manner. Lesson 8: Plan Exercise, Assessment, and Maintenance - Establish and maintain training and awareness programs that result in personnel being able to respond to incidents in a calm and efficient manner. Lesson 9: Crisis Communications - Provide a framework for developing a crisis communications plan - Ensure that the crisis communications plan will provide for timely, effective communication with internal and external parties Lesson 10: Coordination with External Agencies - Provide a framework for developing a crisis communications plan - Ensure that the crisis communications plan will provide for timely, effective communication with internal and external parties Lesson 11: Healthcare Examination Review - Review the important concepts from each lesson - Prepare for the Healthcare Examination ------- For in-person courses: This course will be held in-person and the exam will be online, at leisure. A computer is required for this course in order for you to take the exam. The system requirements will be sent to you via email together with information about how to access the course materials prior to the start of the course. For courses held online: All online courses are held via Zoom and a computer is required for this course. The system requirements will be sent to you via email together with information about how to access the course materials prior to the start of the course. You will also be provided with instructions for how to take the exam online, at leisure following the course. For international courses: This course is being hosted by a DRI International partner. To register, you will be asked to provide your contact information and we will put you in touch with the local team for details. For courses held pre-conference: This course is being held in-person prior to the DRI Annual Conference at or near the conference venue. You can then attend the conference immediately following your course with an additional registration (separate fee applies).

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Business continuity

Information last updated: 20 April 2023

NHS England business continuity management toolkit

This document highlights the need for Business Continuity Management (BCM) in NHS organisations so that they can maintain continuity of key services in the face of disruption from identified local risks. Under the Civil Contingencies Act 2004 and the Health and Care Act 2022 , all NHS organisations have a duty to put in place continuity arrangements. The toolkit is driven by the Plan, Do, Check, Act (PDCA) cycle along with being updated in line with both ISO 22301 principles , as well as the Business Continuity Good Practice Guidelines 2018 .

• View and download: NHS England business continuity management toolkit

Below are sets of supporting documentation to be used as part of the NHS England business continuity management toolkit.

Part 1 of the supporting documentation refers to the ‘Plan’ aspect of the PDCA cycle. Here is where an organisation establishes the Business Continuity Management System (BCMS) by developing a policy, as well as using documentation and templates. This section also allows organisations to embed Business Continuity into their culture.

• Resource A – Business continuity management system
• Resource B – Business impact analysis templates (basic, directorate and interruption)
• Resource B – NHS business impact analysis template
• Resource C – business continuity plan checklist
• Resource D – site business continuity plan template

Part 2 of the cycle is attributed to ‘Do’ element of the PDCA cycle. This section defines business continuity requirements, determines how to address them and develop procedures to manage a disruptive incident. Once your BCMS is designed, it is necessary to implement it successfully. In order to do this, NHS organisations should understand their role and how to complete documentation that is required for the BCMS to be effective.

• Resource A – business continuity management NHS workshop slides
• Resource B – business continuity workshop delegate book
• Resource C – business continuity facilitators guide

Part 3 focusses on the ‘Check’ aspect of the PDCA cycle. This part of the cycle summarises the requirements necessary to measure business continuity management performance for an organisation. It also links to the BCMS compliance and seeks feedback from top management regarding expectations, gaps and inconsistencies.

• Resource A – business continuity exercise staffing reduced availability
• Resource B – business continuity exercise services and suppliers
• Resource C – business continuity exercise – premises unavailable
• Resource D – business continuity exercise – information (unobtainable) and information systems (unavailable)
• Resource E – internal audit checklist

Part 4 of the PDCA cycle refers to ‘Act’. It identifies and acts on BCMS non-conformance through corrective action. The review of your system also allows the potential to make changes based on updated guidance and changes to the organisation.

• Resource A – business continuity debrief template
• Resource B – business continuity action plan template
• Resource C – business continuity management review and potential evidence

Case studies have been put together from various incident debriefs across NHS organisations. This is to provide examples of approaches to incident reports and allow identification of learning across organisations. There are a wide range of examples including WannaCry, utility disruption, power loss etc.

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What Is BCDR? How Health Systems Navigate Crises Using the Cloud

Brian T. Horowitz is a writer covering enterprise IT, innovation and the intersection of technology and healthcare.

When a cyberattack or a natural disaster such as a tornado strikes, healthcare organizations are often unprepared for extended downtime.

“When a healthcare facility experiences data loss or other disasters, the downtime affects more than just the business. It also affects the patients,” says Nataraj Nagaratnam, IBM fellow and CTO for cloud security.

In fact, the average healthcare organization’s downtime following a cybersecurity attack such as ransomware is a little over two weeks, according to Statista.

When health systems go down, the organization stops accepting patients via ambulance or helicopter and reschedules procedures, notes Seth Johnson, industry director for healthcare at Lexmark .

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“It's a cascading effect, and that is a large hit to the bottom line for hospitals running on razor-thin margins,” he says. 

Even if healthcare organizations have not migrated their operations fully to the cloud, business continuity and disaster recovery (BCDR) is one area where the cloud can help.

For example, the Microsoft Azure cloud platform allowed Mount Sinai Health System to be better prepared for outage recovery through cloud-based geographic diversity and failover features. Meanwhile, Cook Children’s Health Care System in Fort Worth, Texas, migrated its electronic health records (EHRs) to the public cloud to gain more resiliency and be prepared for disasters or cyberattacks.

EXPLORE:  Follow these best practices to improve cyber resilience in healthcare.

What Is BCDR?

“Business continuity and disaster recovery refers broadly to the process and steps organizations take to return to normal business operations in the event of a disaster or disruption. It is a key part of crisis management,” Nagaratnam says.

Business continuity plans are much broader and more proactive than disaster recovery plans, he adds. Disaster recovery plans are reactive and allow health systems to resume normal activity with systems intact after an outage.

In addition to downtime, failure to craft a strong BCDR plan can lead to data loss, financial penalties and reputational damage, Nagaratnam says.

While business continuity is the process of maintaining operations during a disaster, disaster recovery is the technical process of restoring connectivity after an outage, explains Al Berman, president of the DRI Foundation, a charitable arm of the Disaster Recovery Institute (DRI) International .

“The world does survive without technology for periods of time,” Berman adds. “We’ve seen that in hospitals, where hospitals continue to function despite the fact that they’re under ransomware.”

DISCOVER: How can healthcare organizations grow with a smarter backup strategy?

How to Craft a BCDR Plan for Healthcare

Health systems should come up with a BCDR plan for what to do at 12 hours, 48 hours and one week post-attack, Johnson advises. He adds that health systems need a plan that documents how to operate without their usual systems in addition to how to get back to a normal state. They can take lessons from aviation: Pilots are good at checklists, and they can deal with both a blown fuse and a loss of engines. Healthcare teams need a similar checklist in the event of a disaster, he says.

In addition, health systems should keep checklists for every department, workflow and critical area — including IT — to maintain processes, Johnson says.

Rajesh Sheth, vice president of AWS Elastic Block Store and backup at Amazon Web Services , advises that healthcare organizations incorporate a recovery time objectives and recovery point objectives in its BCDR plan. An RTO defines the maximum delay acceptable between service interruption and restoration, while an RPO describes how much data loss is acceptable between a service outage and the most recent recovery point. Healthcare organizations must decide on acceptable RTO and RPO thresholds for the organization.

Health systems should also analyze what it would cost to back up to a BCDR cloud, Berman advises, compared with a process like air gapping, which involves isolating a device from outside networks.

Nataraj Nagaratnam IBM Fellow, CTO for Cloud Security, IBM

“It depends on how secure you want to be,” he says.

HER vendors and large tech companies such as AWS and Microsoft have multiple data centers throughout the country, which helps with redundancy during a disaster.

“The key is you have to have that connection,” Johnson says.

Crisis management teams should meet regularly to go through desktop scenarios and determine what happens at each decision point, Johnson recommends. Drill down and make the plans specific, especially for worst-case scenarios, he suggests.

Experts say stress testing is another key aspect of preparing for disasters and the recovery that follows.

“Restoration testing is the way to ensure processes will work when they are needed,” Sheth says. “By using services such as AWS Endpoint Detection and Response , customers can set up continuous, near real-time data replication to a staging environment in AWS.”

In addition, automation through Infrastructure as Code provides another way to reduce the time required to recover from a disaster, according to Sheth.

LEARN MORE: Backup as a Service can boost data protection.  

How Health Systems Use BCDR Solutions

As health systems get IT operations running again after a disaster, the cloud will be critical to helping them share information electronically. Services such as IBM Cloud Cyber Recovery provide cyber risk mitigation and an isolated, cyber-resilient infrastructure to prepare for ransomware and advanced cyberattacks. Meanwhile, the AWS Well-Architected Framework  allows organizations to establish business continuity and disaster recovery objectives.

After a disaster or a cybersecurity incident, hospitals might find themselves back on paper. Lexmark’s Downtime Assistant lets health systems store medical records and forms in an encrypted storage device to prepare for massive downtime , Johnson says.

“If you do have to go back to pen and paper, we can store clinical information and downtime medical record documents on a device that can be a kiosk in the middle of a chaotic situation,” Johnson says.

A tornado occurred years ago at a health system Johnson was working at in East Tennessee. When a billboard came down and slashed the hospital’s fiber line, the organization used the Lexmark Downtime Assistant to print a checklist and documentation.

“Even if Downtime Assistant is plugged into a generator or on an uninterruptible power supply that machines can still work on, providers can print on demand everything they need to create a downtime record and keep taking care of their patients,” Johnson says.

UP NEXT: Discover how to increase your ransomware recovery capability.

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Business Continuity Management For Hospitals and Healthcare

As a leading healthcare investor in Jacksonville, Florida, you need to be aware of this sector’s threats. Lately, the medical industry has seen ransomware attacks and other cyber challenges such as business email compromises, insider cyber threats, data breaches, and Distributed Denial-of-Service (DDOS). The healthcare industry should be the last sector that cybercriminals should attack, but there are no exceptions when threat actors look to make money. Unfortunately, cyber threats are not slowing down. As such, it’s critical to introduce business continuity management (BCM) in your medical facility to prepare in advance.

BCM will keep your organization operational when such threats strike. 

What is Business Continuity Management (BCM)?

Business continuity management (BCM) is an organizational framework and procedure formulated to identify possible threat exposures . In this framework, an organization lists all external and internal threats while highlighting the appropriate measures to deal with such threats. 

In this case, a business continuity plan will give your medical company the ability to respond to the cyberattacks discussed above. Additionally, your business will be aware of the likelihood of cyberattacks and the appropriate actions to consider when these threats become a reality. 

Notably, a business continuity plan is not only critical in dealing with cyberattacks. This is only one of the areas where it can bring peace of mind. However, this strategic plan also helps in addressing other threats to your business, such as:

• Weather incidents such as tornadoes and hurricanes
• Supply chain disruptions
• Operational failures and stalls
• Technological outages
• On-premise accidents, etc.

What is the Purpose of Business Continuity Planning?

The current data indicates that 1 in 2 businesses experience an extended break in continuity after disruptions. In addition, a significant percentage of companies in various industries don’t recover at all. That’s why you should focus on incorporating a business continuity plan in your medical facility. Its ultimate objective is to keep your organization running productively and smoothly in an emergency. 

According to Verizon Business Report, 28% of data breaches in the country today affect smaller companies. Therefore, your medical facility will encounter a human-caused or natural disruption at some point. Business continuity management ensures that, when such disturbances occur, they’re contained and controlled before affecting your company. 

As discussed below, business continuity management will offer other benefits to your medical organization. 

1. Organizational Assurance

Today, people are highly concerned about the preparation of their community organizations if a disaster occurs. Therefore, you need to ensure that people leading your medical facility have the necessary plans to deal with disruptions. Other significant parties that require an assurance of your organization’s preparedness include partners and third-party vendors. 

You also need to comfort your workers and inform them of the steps you’ve incorporated at the company to deal with possible eventualities. Clear communication between management and the employees helps to eliminate potential confusion that tends to strike organizations experiencing an emergency. 

2. Continued Service Excellence

Healthcare organizations play a central role in any community. Slight disruptions can easily pose some huge healthcare threats to the people who have been accessing services from such facilities. This was a common trend when the majority of the medical facilities were overwhelmed by COVID-19 infections . 

However, your Jacksonville medical facility will quickly deal with extreme cyber emergencies with a business continuity plan. Your operations will pick up where they left off, which means you’ll continue to serve your customers and deliver the expected value while maintaining the integrity of your medical facility. 

3. Decreased Downtimes

Gartner indicates that technology outages cost small and medium businesses around $5,600 per minute. The more your organization remains grounded, the higher the losses. Therefore, the objective should also ensure that your medical facility resumes its operations immediately after a cyberattack. 

Typically, small and medium enterprises take two days to resume operations after a significant cyberattack. However, those with a  business continuity plan  resume operation immediately. In addition, there are substantial financial benefits to companies with such plans. 

4. Risk Management

Some disruptions can quickly escalate and lead an organization to massive failures. Previously, some simple troubles have snowballed into existential organizational crises due to poor continuity management plans. For example, approximately  100,000 businesses  closed their operations permanently after COVID-19 disruptions. 

Business recovery plans also play a vital role in managing risks. They focus on managing the costly risks by ensuring there are seamless and efficient management approaches that will prevent catastrophic failure. 

5. Enhanced Business Reputation

Customers are consistently analyzing how entities maintain their reputation and brand image in the face of adversity. Unfortunately, organizations in the medical industry don’t have much room to make mistakes. Slight errors in addressing disruption and a medical facility plummet into deep reputational crisis. 

Today, cyber threats have led to reputational damages in various organizations. Therefore, you need to have continuity plans to protect healthcare records against infiltration and ransomware. This will help maintain the reputation of your medical clinic in case of extreme cyber issues. 

6. Maintain a Competitive Edge

You’re not the only medical facility in Jacksonville, FL. Other healthcare facilities are also working hard to attract your clients. Therefore, you must be in a perpetual mood of improving your operations and provide for unseen threats that can harm your business. 

If you have a recovery strategy in place, it will be easier to maintain your operations. But, at the same time, other medical facilities will be stuck in a cyber-attack affecting your region. So, you’ll undoubtedly stand out as a company that customers can count on. 

How Can You Create a Business Continuity Plan?

If you don’t have a business continuity management plan in place, here are some simple steps you can follow. 

1. Conduct a Business Impact Analysis

In this case, you’ve to determine your most valuable operations. Next, the personnel and technology that undertakes such procedures should be defined. The ultimate objective of conducting an impact analysis is to determine how disruptions will affect your organization. 

Also, business impact analysis helps to determine areas of vulnerability. If you already know the weak spots that hackers can exploit, you can develop the necessary measures to address such weaknesses. 

Importantly, business impact analysis presents a clear picture of your organization’s threats. It also highlights the expected losses and downtime projections. This information will help you to formulate a business continuity checklist. 

2. Explore Recovery Options

With a business impact analysis in place, your medical facility can now move into the next step-vetting possible replacement options. Remember, replacement and recovery strategies are the backbones of your organizational continuity. 

You already know the weak areas that can attract hackers into your organization. Therefore, you should be working on the possible infrastructure that can minimize threats.

Identifying the gaps is not enough. Instead, you need to go into the next step and determine the next cause of action. It’s the only way to close the gaps as well as deter the risks likely to disrupt your organization. 

3. Create the BCP Framework

You’ve identified the risk areas and formulated the necessary replacement strategies. The next step is to establish an official business continuity framework. This is a document that will outline your step-by-step disaster preparedness plan. 

In the business continuity plan, you should have a team to implement the recovery policies. As a small medical facility, you’ll be the head of the group comprising other influential experts in your organization. 

A relocation plan should also be incorporated. New locations will form where your medical facility will continue delivering services if it experiences extreme natural disasters or sustained cyberattacks. Other essential aspects include backup technology as well as disaster recovery vendors.

4. Implement the Business Continuity Management Plan

Your medical facility should be prepared to implement its formal business continuity plan. In this step, you should institutionalize the teams, actions, as well as outsourced services highlighted in step three. 

Your employees should be familiar with all the backup and replacement strategies your organization will implement in case of a disaster. Ensure that all the workers and the BCP teams know the new backup technologies for a seamless recovery. 

5. Testing the Business Continuity Plan

Testing your continuity plan is the final part of your preparations. Next, you need to make sure that all the employees in the organization continuously test and practice their roles for efficiency and effectiveness. 

Pre-planned mock emergencies will be the best technique for testing your BCP. They’ll offer insight into the effectiveness of your plan and the possible areas of improvement. 

Remember, threats are constantly changing . Therefore, you should also review and improve your coping mechanisms. It’s the only way you will respond to the growing dangers of cyberattacks.

How Can NetTech Consultants Help in Business Continuity Management?

At  NetTech Consultants , we focus on assisting small and medium companies in Jacksonville, Florida, in  managing data backups and disaster recovery . In addition, we’ll help you test your data backup and disaster recovery plan to ascertain the effectiveness of your medical facility if disaster strikes. 

As an IT support company, we want to handle the technical aspects of cyber security as you focus on what matters-attending to your patients. We’ll provide extensive support and total satisfaction in:

• Network support
• Computer and mobile support
• Server support and 
• Managed IT support

Are you worried about the growing cyber security attacks in the healthcare industry?  Contact us today  for a productive and collaborative business continuity plan. 

The NetTech Content Team

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