• Sweden edition
 

Patient records wiped out in system crash

Published: 17 Sep 2011 09:07 GMT+02:00
Updated: 17 Sep 2011 09:07 GMT+02:00

When the computer systems in Skåne crashed on August 22, not only did it take with it patient appointments and prescriptions, but it may have wiped out up to 50,000 patient records.

Region Skåne, the self-governing authority for south of Sweden, shipped the affected hard drives to a Norwegian company that specializes in data recovery in an attempt resuscitate vital patient information.

”The job is still on-going and they’ve had to bring in specialists from the United States,” Lennart Wallen, who, until earlier September served as the IT-Director for Region Skåne, told Dagen’s Nyheter (DN).

The cause of the system crash is still not known and the exact extent of lost information has yet to be determined, which has raised grave concern within the National Board of Health and Welfare’s (Socialstyrelsen) southern region’s branch.

”We have never before lost so much information,” Mette Marklund, director of the National Board of Health and Welfare’s Southern Region, told DN. ”It can be a great risk to patient safety when we do not have access to adequate information. But, we do not know yet what to rebuild.”

IT-departments in Skåne managed to rescue ’reading copies’ of patient records, but no one is able to confirm if this version of patient records is complete or identify what may be missing.

After the system-wide crash, medical staff resorted to pen and paper for medical notes and continues to manage lab results manually.

”The databases are still broken, so sometimes you cannot get hold of the data you are looking for. It is quite a sluggish job,” Marklund added. ”We believe that we have not really lost any data, but we won’t know with certainty until we hear from Norway.”

Region Skåne is scheduled to launch a central medical record system for the entire nation in 2012.

Karen Holst (kholstmedia@gmail.com)

Your comments about this article

10:02 September 17, 2011 by Keith #5083
ermm...uhhhmmmm...2 words.....BACK UP!!!!
10:33 September 17, 2011 by henryo
I can support the hospital to recover all the formatted data or patients' records from the hard-disk.

I have expertise in data recovery and have supported several organizations recover lost data in the past.

TheLocal, you can send my contact email to the hospital, I will fix the problem in 8 hours within the office of the hospital.

My mobile is 0735910086.
11:15 September 17, 2011 by vancer
I will do it in 4 hours and half the price of henryo
12:20 September 17, 2011 by Opinionfool
I'll reduce Keith's comment to one word: backup. And to Marilyn, you have no experience of hynryo's professional competencies in dealing with this issue. Data recovery is a difficult and expensive task. He may have the necessary skills but, as an IT consultant myself, his figure of 8 hours is over optimistic. Some simple maths is all that is necessary to show so. 50,000 records all needing to be examined to ensure that nothing has been obviously corrupted. At a very conversative 1 minute per record-check that's 833 hours (105 working days; no single person could work consistently for 35 days 24 hours a day) ... after the information has been recovered. Noice the "obviously" that's simply a scan to check that doctor's notes are text, and that scanned material (X-rays, MRIs, consultant's reports, etc) look as they should. It will take longer to ensure that this apparently correct text, scan, (repeat) prescriptions are linked to the correct person. Plus did this crash corrupt the disk(s), the file system or the database. Finding an answer to that will require several hours of highly intensive forensic work. But the question implicit in Keith's comment remains why did no one do regular backups? Professional organisations do daily backups, whether these are always full backups or a weekly full with daily incremental backups (only modified files/records are backuped) is irrelevant. There must be backups. If they had then the problem reduces to what was changed since the last backup was completed and the moment the system crashed. Real-time systems, which appointment bookings are, need specialist backup mechanisms. And why wasn't the system "mirrored"? For those who understand I don't mean RAID 1 mirror (one disk to another) but whole system mirroring. These days of off-the-shelf systems with open source operating systems bring the cost of total system duplication down to levels that even a start-up company can afford to install. And mature open source SQL databases such as MySQL and postrgreSQL have replication as standard features. There really is no excuse for a simple systems failure like this to take out an organisaiton. If the health districts wants so real IT consutancy to make sure such a situation never happens again then The Local can send *my* contact details on.
14:22 September 17, 2011 by Scepticion
I agree with Opinionfool.

In fact, I have seen incompetent IT administration in several other public organizations. Heads should roll, this should not happen for such sensitive material.
14:48 September 17, 2011 by Opinionfool
While I didn't mention recrimination I agree with Scepticion those responsible for this debacle should lose their jobs. Whether software architect who "designed" the system, the system managers who should have followed standard operating procedures by taking backups, or accountants who insisted on lowest bid (aka least functioning system).

Systems design is not easy. It requires a mind that says "what can go wrong?" not one that says "this is the functionality required that's what we will deliver." And as Scepticion says the information being handled here is sensistive -- life and death even; well would you want to be given the wrong drugs/treatment because your record was corrupted and linked to the wrong medical protocol? We trust too much to the technology rather than thinking about the issues involved.

Complex computer systems are hard, very hard, to get right and it doesn't need people saying "I could've fix that in N hours." getting the design right in the first place means that failures do not have such aweful consequences. Pareto's rule applies; spend 80% of the project on design and 20% on implementation and debugging. Sadly most projects are driven by those who want code or to code so 20% of a project is spent in design and 800% (sic) is spent in programming and debugging.

A rider to my comment above. Even The Local's database system gets corrupted. When I commenced typing that commentI was logged in but when I clicked the "Submit" button a few minutes later it had lost my status. It then stopped me from adding this paragraph as a comment until others had submitted their comments.
15:14 September 17, 2011 by Opinionfool
Indeed one should backup data. Even householders using their own home machines should do so. It is clear however that in this case no one bothered. If they had have done so then most of the records would be recovered back to no later than the close of business the day before the crash.

As to virus protection anyone who runs a sensistive-data system on an operating system that requires virus protection should also lose their job for just suggesting such a thing. (And yes there are operating systems out there that do not require virus protection at all. We don't all lamely follow Microsoft.) Plus what **** is a system holding personal and deeply sensistive data doing being connected to the Internet anyway? Put a gateway between it in a DMZ maybe, but never ever run such a service on a system so easily susceptible to security breaches as one requiring anti-virus software.

I agree with you, backups must be done regularly at least daily. Better if the system is designed to do real-time backups for example through replication of data to a separate parallel system. But as is clear to anyone with the modicum of systems management experience the backups simply weren't being done in this situation.

As to "making money" I never said any such thing in my own offer. I had typed but then expunged "pro bono provided that food, drink, accommodation, and all expenses are included" but that would have reduced it to the same childish level as the original. And the second offer is clearly meant sarcastically to show up the stupid of the "I can do it in 8" claim. I had no thought of making money; I'm not driven by such capitalistic notions. But don't you mean "profit". The people who will pay as a consequence of such mis-management are the patients whose treatment is now disrupted because their information has to be recovered after someone's negligence.

(By the way I work on data-in-the-huge database projects.)
16:34 September 17, 2011 by Addendum
Who do you have to blow to get an MRI, X-ray, etc.?
18:45 September 17, 2011 by AnnicaE
@Addendum

Never tried to see a doctor? Or have you diagnosed yourself and want an MRI or X-ray to confirm? I don't even think you have to give anyone a blow!
19:06 September 17, 2011 by Opinionfool
@Marilyn vos Savant

"Refreshing"? In what way refreshing? Someone posts that they could solve the intricate repair problem in 8hours, when even a back-of-the-fag-packet calculation would show that such a time period is simply non-sense.

Refreshing? In what way refreshing? That someone posts a random mobile number on a public comment forum so you believe they are competent.

As to jumping to conclusions, well maybe but those are conclusions based on a career in IT dealing with systems design and systems management. I think my conclusions are based on something more solid than "refreshing".
21:38 September 17, 2011 by Keith #5083
Perhaps instead of 'rolling heads' those with direct managerial responsibility for this infantile situation should at least be required to pay for the sys restoration!

Once the lesson is learnt, perhaps it won't ever happen again.
21:39 September 17, 2011 by Addendum
If

If you can keep your head when all about you

Are losing theirs and blaming it on you;

If you can trust yourself when all men doubt you,

But make allowance for their doubting too;

If you can wait and not be tired by waiting,

Or, being lied about, don't deal in lies,

Or, being hated, don't give way to hating,

And yet don't look too good, nor talk too wise;

If you can dream - and not make dreams your master;

If you can think - and not make thoughts your aim;

If you can meet with triumph and disaster

And treat those two imposters just the same;

If you can bear to hear the truth you've spoken

Twisted by knaves to make a trap for fools,

Or watch the things you gave your life to broken,

And stoop and build 'em up with wornout tools;

If you can make one heap of all your winnings

And risk it on one turn of pitch-and-toss,

And lose, and start again at your beginnings

And never breath a word about your loss;

If you can force your heart and nerve and sinew

To serve your turn long after they are gone,

And so hold on when there is nothing in you

Except the Will which says to them: "Hold on";

If you can talk with crowds and keep your virtue,

Or walk with kings - nor lose the common touch;

If neither foes nor loving friends can hurt you;

If all men count with you, but none too much;

If you can fill the unforgiving minute

With sixty seconds' worth of distance run -

Yours is the Earth and everything that's in it,

And - which is more - you'll be a Man my son!

R. Kipling
21:47 September 17, 2011 by Opinionfool
Keith #5083

I too would like to believe that but there's a huge pile of anecdotal literature in computer science that says the exact opposite. These failures happen time and time and time again without the necessary lessons being learned.

Penalising the current management team might make them get it right next time. The problem is they should never have got it (so) wrong this time.
13:04 September 18, 2011 by Keith #5083
Yes, it's so good that many offer to help.......so here's my FREE offer: for the expertise, professional qualifications, impressive customer list (leading companies e.g. Apple, Sony, etc.), and proven superb rebuild program - check out Gibson Research's Spinrite prog.

Oh, but if you are not smart enough to BACKUP maybe you shouldn't try to use a prog like this - better to contract the rescue out - then you have someone else to blame if it can't be recovered.

Oh, and just a side note about facts: phone numbers that do not register with orgs like hitta.se don't inspire one to make contact with an unknown ´professional', though the offer to help was still an apparently worthy attitude.
14:48 September 18, 2011 by Opinionfool
Wow thanks Marilyn for your fantastic insight into how to identify properly qualified IT professionals, all it takes is to come here and give one's phone number. Thanks I'll remember that in future. It is the IT version of "trust me I'm a doctor."
18:55 September 18, 2011 by Opinionfool
MvS I suggest that before you suggest where anyone goes that you check henryo's profile. It was created yesterday and they have posted exactly one message; the one above. That's the hallmarks of a troll.

But hey I'm happy to take the intelligence prize --- if you'll accept both the gullibility and naivety awards.
01:21 September 19, 2011 by Keith #5083
#MVS

Yes, I stand corrected. It does show on Eniro..but did not show on hitta at the time of my posting - nor does the name/address listed at eniro show on hitta at the time of this posting.

My profound thanks for your analysis of my motives/methodologies/prejudices. I am sure you enjoyed writing it as much as I was amused reading it.
12:42 September 19, 2011 by Keith #5083
#MVS

as with many old things, updates are necessary (as we 65 year olds know) for the modern technological age.So if you will kindly permit, I would respectfully suggest:

" A wise person changes their mind when the experiential evidence suggests it is necessary. A fool is forever changing minds".

I have removed the 'sexist' element from the 'old proverb' in the interests of equality.Not everything that is old is necessarily beneficial today - though perhaps clerks instead of computers may have served these 14 clinics and 2 major hospitals better in the light of events.
20:59 September 19, 2011 by Keith #5083
#MVS

In order to concede your point we would have to agree on the definition of a proverb.wikipedia definition suggests a common acceptance and/or practical experience. Unless, of course, you are referring to some Biblical 'proverb' which was written in stone thousands of years ago.

As for change, well the only constant is change.

If change had been applied to the thinking behind the debacle to which this article refers, perhaps a backup in time would save nine re-writes.
23:33 September 19, 2011 by Keith #5083
#MVS

If you are the real MVS then arrogance is probably the wrong terminology, I respectfully suggest :-)

But it was nice to reach a point where we could both say 'agreed'.Many thanks for a stimulating discussion.

Have it good.
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