Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA.
University of Vermont Health Network, Burlington, VT, USA.
Am J Clin Pathol. 2022 Jul 1;158(1):18-26. doi: 10.1093/ajcp/aqac004.
Our institution was the victim of a cyberattack that necessitated use of manual laboratory systems for more than 25 days. These manual processes had to be created not only to enable us to process our case volume without bottlenecks but also to maintain patient safety and allow for billing.
Our laboratory needed to create a safe reporting process to ensure ongoing patient safety and error reduction during the downtime. Additionally, we needed to ensure the ability to bill for performed tests in some areas of the lab and maintain compliance with regulatory policies.
Amendment rates in our system were higher than before the attack, but no patient harm was observed. Intraoperative assessments declined, but high-acuity cases continued with a discrepancy rate comparable with the normal state. Many hours and resources (human and otherwise) were necessary to reconcile the work done to bill for services, but we were able to capture revenue through careful planning.
This article records the challenges we faced and the successes we achieved in maintaining compliance and a low error rate in the face of manual processes, the steps necessary to bring the cases into the newly restored electronic health record, and how we billed for the services we rendered.
我们机构遭受了一次网络攻击，这导致我们超过 25 天的时间不得不使用手动实验室系统。这些手动流程不仅是为了使我们能够处理我们的病例量而不会出现瓶颈，而且也是为了维护患者安全并允许计费。
我们的实验室需要创建一个安全的报告流程，以确保在停机期间持续的患者安全和减少错误。此外，我们需要确保在实验室的某些区域能够对已执行的测试进行计费，并符合监管政策的要求。
我们系统中的修正率高于攻击前，但没有观察到患者受到伤害。术中评估有所下降，但高风险病例仍在继续，差异率与正常情况相当。需要花费大量的时间和资源（人力和其他资源）来核对计费服务所做的工作，但我们通过精心计划能够获得收入。
本文记录了我们在面对手动流程时所面临的挑战和取得的成功，包括将病例纳入新恢复的电子健康记录所需的步骤，以及我们如何为提供的服务计费。
