Business continuity planning helps you get your practice up and running after disaster strikes

by Stuart Foxman

Doctors are used to dealing with the unknown and responding on the fly. Emergencies are part of the job. If plan A doesn’t work with a patient, go to plan B or C. That’s true when it comes to day-to-day medicine. But what about running your practice? 

Any workplace should prepare for the unexpected. COVID-19 offers many lessons, among them the importance of contingency planning.  

A pandemic may be an extreme situation, but it isn’t the only one that can disrupt a practice. Imagine the impacts of fires, floods, power outages, natural and human-made disasters, severe weather, vandalism, data corruption or malfunctions, and community crises. You can’t predict such events, but you can plan for them.  

Start Planning

Start by considering the possible repercussions, says Ann Wyganowski, a business continuity consultant based in Port Carling, Ontario. She has worked with hospitals, as well as utilities, municipalities, property managers, retailers, and more. “I try to make people believe the worst things that can happen,” she says. 

That could involve losing access to a clinic or building, staff, medical equipment, EMRs and patient data, computer hardware/software, or Internet and communication services. 

Any of these things can happen, in any combination, for any duration. Think Godzilla, Wyganowski tells clients. The movie monster walked through power lines, smashed buildings and caused widespread mayhem.  

“Make reasonable assumptions, but don’t get overly positive. Godzilla stepped on your place of work – what do you do now?” says Wyganowski, who’s also an instructor with the Disaster Recovery Institute Canada. 

The short-term goal of contingency planning is to restore your practice to a minimum acceptable level of operation. Long term, you want to resume to your pre-incident condition.  

You can find guides and templates from:

• OMA Quick Guide to Business Continuity Planning for Physicians  
• Insurance Bureau of Canada
• Business Development Bank of Canada
• You can also visit the Ontario government’s “COVID-19: Support for Businesses” web page for general information and resources for your practice or check with the emergency management office for your municipality. 

Resources like these, or business continuity experts, can help with the how-to specifics. But many of the broad plan elements are common. Here are some of the main areas to consider when developing your plan: 

• Assign a lead. That’s the person who will spearhead continuity efforts (e.g., the clinic manager or a physician lead), including assessing levels of risk to your people (patients, staff), the infrastructure, and critical processes. No matter who the lead is, the person or people ultimately responsible for the practice owns the plan. 
• Prepare staff. How would you account for office staff absences? Can you cross-train staff (for office and medical functions) in case not all are available? What non-essential tasks could pause? How will you manage HR (i.e., supervising staff from afar)? Consider your rights as a worker and responsibilities as an employer. 
• Manage patient flow. Determine how to identify and cancel non-essential visits, communicate with patients, and change office procedures. 
• Assess alternate delivery of care. During COVID-19, remote care was one option. But if the next virus is a computer virus, even that could prove difficult. Consider where care might take place temporarily, and in what form. 
• Understand backup protocols for key tasks. What if the EMR is unavailable, or if the typical process for lab interfaces or writing prescriptions is interrupted? 
• Think about your vital records. Review how your critical files/information are stored and backed up, and how you can access them. Do you have the technical capabilities to quickly access extremely large files (e.g., diagnostic imaging)? 
• Co-ordinate with outside suppliers. A range of services and products support your patients. Have the contact lists and agreements with those vendors handy so that you can make alternate arrangements. 
• Look at your overall functions. It’s smart to conduct a business-impact analysis, says Wyganowski. That examines what you deliver and how, and the interdependencies between everything. An analysis could reveal opportunities to structure yourself in ways that make it easier to carry on business.  
• Review insurance coverage. Aside from business interruption insurance, other coverage can address individual risks, like cyber insurance. Your broker can evaluate your range of risks, review what’s included or excluded in your policies, and recommend strategies. 

Review and Refresh Your Plan as Needed

Contingency planning isn’t a one-off. Risks can change, and so can your practice. Hold regular reviews, refresh the plan as needed, and train and educate staff. 

“Everyone should understand their roles and responsibilities, and the actions they’re responsible for prior to the time of the incident,” says Wyganowski. 

She says it’s also prudent to test technology and access to critical information from an alternate location. 

With a table-top exercise, you can run through a scenario, see how your plan would apply, and tweak as needed. Make an easy-to-follow checklist too; no one should have to think up the key steps to take at the time of the unforeseen business disruption. 

While doctors have a duty of care, Wyganowski notes they also have an obligation (including a fiduciary one) to manage risk for their practice. If you’re in a multi-tenant medical building, for example, the property manager will have their own emergency procedures. But they are not the one to get your practice back up and running. 

“Hopefully, this gets more people thinking about being more resilient and prepared,” says Wyganowski. 

A continuity plan can offer more than peace of mind. By diving into all the dimensions of your practice and how it can operate, you may discover different options and efficiencies. 

“Often, you can find new ways to do business,” adds Wyganowski. ”It focuses you to think about how to do things better.”  

Stuart Foxman is a Toronto-based writer.