In this two part blog, Pedro Carvalho, Solutions Architect at BridgeHead Software, discusses why a Clinical Data Repository saved the day for healthcare customers who recently experienced unplanned system downtime, referencing two real-life situations.

The pain of unplanned system downtime for healthcare staff

I’m sure you’ve all been there but, for those that haven’t, picture this…

You’re in the midst of a busy shift at the hospital with patients lining department walls patiently waiting for their consultations, scans, tests, treatments when suddenly – BAM! Your EHR or clinical system goes down for an unscheduled nap. Cue the collective groans and frantic scrambling. You find yourself trying to navigate a maze blindfolded. You know every minute counts in healthcare, but this downtime feels like an eternity. You find yourself struggling to access the crucial patient data you need resorting to your paper records as a backup (but where are they?) and, ultimately, praying for the system to resurrect itself… and fast. This is all stress, pressure, and chaos you could really do without at a time when staff morale is already waning and burnout rife.

For our customers, these unplanned downtime events can sometimes just be a ‘hiccup’ and are quickly resolved. However, in other cases, it can scale to a full-blown crisis, one that directly impacts clinical and operational efficiency, loss of revenue, and, most importantly, patient safety and care.

As a leading healthcare data management company, BridgeHead is all too familiar with these scenarios. Healthcare organizations the world over experience unplanned downtime events with some regularity. So, I thought I would share a couple of recent, real examples of situations where our customers have suffered from unplanned outages of their mission critical systems and how they significantly reduced the pain that usually goes hand-in-hand with such incidents.

The PACS is down!

Earlier this year, one of our customers went live with a new radiology PACS. There’s nothing unusual about this – a PACS refresh typically occurs, on average, every 5 years or so. The customer had carried out their due diligence via a robust market engagement and procurement process settling on the solution that best suited their requirements. Job done.

But we don’t live in a perfect world and ‘shiitake’ happens. One day, not long after ‘go-live’, the organization in question found themselves on the receiving end of an unplanned radiology PACS outage. Oh joy!

Ordinarily, it’s not pretty when a PACS goes down. The radiology department is core to hospital operations in diagnosis and treatment planning. Clinicians rely on the radiology PACS application to quickly retrieve, review, and report on X-rays, MRIs, CT scans, and other imaging studies in order to drive care decisions for patients. Without access to these critical images, patient care can be compromised, with potential delays in treatment, misdiagnoses, and even medical errors.

PACS downtime also creates a logistical nightmare for radiology departments. Productivity takes a nosedive with highly-skilled radiologists and radiographers essentially trapped, unable to perform their duties. There’s no way to upload new images, interpret studies, or communicate findings across the organization or with other healthcare providers. Meanwhile, patients are left waiting, wondering why their appointments are delayed or why their results aren’t available.

Unplanned downtime also puts a huge strain on hospital resources and finances. Every minute that a PACS is offline translates to lost revenue. Hospitals may need to allocate or bring in additional staff to manage the crisis. In some cases, patients may even need to be re-routed to other facilities for imaging services.

And then there’s the potential of reputational damage and all important patient trust. In today’s digital age, where technology is supposed to enhance healthcare delivery, experiencing downtime can feel like a big step backward.

However, I am delighted to say this wasn’t the case for our customer. Let me explain…

CDR to the rescue

So, in this scenario, yes – the customer’s PACS unexpectedly went down. Yes – this did trigger an initial stress response (as these things generally do). But, this particular healthcare organization had designed its Enterprise Imaging strategy with inbuilt resilience. You see, not only had the healthcare provider procured a new PACS; at the same time it also bought a Clinical Data Repository (CDR).

Essentially, the customer had identified the need, as part of its Enterprise Imaging strategy, to aggregate and centralize all of its medical images from across the organisation, past and present. The Clinical Data Repository was implemented to do this job – effectively, to consolidate, store, protect, and provide access to all of the medical images from across the organization. The first phase of the project focused on ingesting all of the customer’s radiology studies into the CDR. Data from other clinical disciplines, such as cardiology, dermatology, endocrinology, ophthalmology, endoscopy, and more; would follow in subsequent phases.

One of the myriad benefits the Clinical Data Repository provided was a failover capability. In this particular case, with the customer’s PACS down, the CDR swung into action. Radiologists were not only able to access all of the recent images generated by the radiology modalities, they also had the ability to view all of the priors for the patient (historical images) using the CDR’s integrated, zero-footprint diagnostic viewer. This enabled clinical service to continue, i.e. radiologists could carry out initial and secondary readings of patient’s scans and generate reports (as the radiology information system (RIS) was still operational). This workflow prevented the radiology department from grinding to a halt; and continued right up until the PACS was brought back on line some many hours later. Ultimately, crisis averted!

Conclusion…or is it?

To say the customer was delighted is an understatement! But that’s why we do what we do. As a customer-focused organization, it gives us an enormous sense of purpose when we are able to help mitigate the impact of situations such as these. My aim in this blog wasn’t to extol all of the benefits of a CDR, but to show how it can add significant value in planned and unplanned downtime situations. To that end, I have another customer story I’d like to share about what happened when a Cloud instance went down. But, I am going to save that for next time – so watch this space for part 2.


With 26 years in IT and over 15 years specializing in PACS, Pedro excels in analyzing, designing, and documenting client environments. As a subject matter expert, he contributes to pre-sales engagements and bid teams, playing a pivotal role in securing significant contracts. Pedro’s responsibilities also involve collaborating with business partners and vendors to plan and design implementation projects for BridgeHead’s Clinical Data Repository, HealthStore. He brings strong leadership skills to guide project direction and scope.


Outside of his professional life, Pedro leads a church choir and the local parish council. He actively participates in and organizes charitable events for the community.


To learn how BridgeHead’s Clinical Data Repository can help alleviate the pain of planned and unplanned system downtime in your healthcare organization…