We have "downtime" systems in place, basically an isolated Epic cluster, to prevent situations like this. The problem is that this wasn't a software update that was downloaded by our computers, it was a configuration change by Crowdstrike that was immediately picked up by all computers running its agent. And, because hospitals are being heavily targeted by encryption attacks right now, it's installed on EVERY machine in the hospital, which brought down our Epic cluster and the disaster recovery cluster. A true single point of failure.

Can only speak for the UK here, but having one computer system that is sufficiently functional for day-to-day operations is often a challenge, let alone two.

My hospital's network crashed this week (unrelated to this). Was out for 2-3 hours in early afternoon.

The "downtime" computers were affected just like everything else because there was no network.

Phones are all IP-based now; they didn't work.

Couldn't check patient histories, couldn't review labs, etc. We could still get drugs, thankfully, since each dispensing machine can operate offline.

There are often such plans from DR systems to isolated backups to secondary system, as much as risk management budget allow at least. Of course it takes time to switch to these and back, the missing records cause chaos (both inside synced systems and with patient data) both ways and it takes a while to do. On top of that not every system will be covered so it's still a limited state.

Yes buy the more high available you do the more it costs and it's not like this happens every week.

As I was finishing my previous costs it occurred to me that costs are fungible.

Money spent on spares is not spent on cares.