Healthcare’s Fragile Infrastructure: Outages Expose Telecom Reliance and Need for Redundancy
Healthcare facilities are increasingly vulnerable to disruptions in patient care due to breakdowns in telecommunications infrastructure. Recent large-scale outages, including the July 2022 Rogers Communications failure in Canada and the July 2024 CrowdStrike software update issue, have highlighted the critical need for redundancy and resilience in systems that support everything from electronic health records (EHRs) to virtual care appointments.
The Rogers Outage: A Canadian Case Study
On , a network upgrade by Rogers Communications inadvertently crashed its core routers, cutting off service to over 12 million users in Canada. The outage significantly impacted healthcare providers and patients, disrupting basic functions like faxing prescriptions and scheduling appointments. Family medicine clinics and long-term care facilities experienced loss of access to critical systems, including provincial COVID-19 vaccination management systems and electronic health records. The disruption was particularly acute in remote locations reliant on network access for specialist consultations.
Michael Garron Hospital (MGH) experienced indirect impacts, primarily affecting corporate staff reliant on Rogers cellular services. Amelia Hoyt, MGH’s Chief Information Officer, explained that the hospital quickly assembled an emergency command center to identify affected staff and establish alternate communication routes. The incident prompted MGH to invest in eSIMs from a different cellular provider for corporate mobile devices, creating a redundancy layer to ensure continuity of service in future outages.
CrowdStrike Incident Disrupts U.S. Healthcare
More recently, on , a faulty update to CrowdStrike’s cybersecurity software caused widespread system crashes, impacting an estimated 8.5 million Microsoft systems globally. University Health Network (UHN) in Canada experienced disruptions to EHR access, telemonitoring, operational management, and research. UHN mitigated the impact by utilizing downtime procedures, including switching to manual documentation and rescheduling non-urgent appointments.
Carl Virtanen, chief technology officer for UHN Digital, noted that UHN’s existing protocols, which prioritize critical areas like emergency departments and intensive care units during technological problems, proved effective. All critical clinical systems were restored by the end of the day the outage began.
The Importance of Redundancy in a Complex Ecosystem
The interconnected nature of the healthcare ecosystem, while facilitating efficient data sharing, also creates vulnerabilities. A single point of failure in the underlying telecommunications infrastructure can have cascading effects. Redundancy – the duplication of critical system components – is therefore paramount. This can range from physical infrastructure, like multiple fiber-optic cables, to software-based backups, such as alternate cellular providers for mobile devices.
While redundancy can be cost-intensive, particularly for facilities with limited resources, the potential consequences of system failures necessitate investment. Hoyt noted that MGH had even considered low-tech backups, like walkie-talkies, to ensure communication during outages.
Accountability and the Role of Telecom Providers
The financial impact of telecom outages is often addressed through vendor refunds and credits, but this framework may be insufficient when essential services like healthcare are affected. Hoyt argues that telecommunications should be treated with the same standards as critical services like 911, requiring providers to meet specific reliability expectations.
In response to the Rogers outage, thirteen major Canadian telecom companies signed the Memorandum of Understanding (MOU) on Telecommunications Reliability in . This agreement commits signatories to provide emergency roaming and assistance during major outages, building redundancy into the Canadian telecom system. Hoyt acknowledged the MOU as a “positive step,” but emphasized the need to see it implemented effectively during future disruptions.
A key challenge lies in the increasing reliance on third-party services, such as cloud-based software-as-a-service models. While these services offer scalability and cost-effectiveness, they also introduce a level of risk that is beyond the direct control of healthcare organizations. Hoyt explained that when infrastructure is managed by external providers, like Amazon Web Services (AWS), local IT teams have limited ability to address disruptions. Healthcare organizations must carefully weigh these risks when choosing to rely on such services.
As healthcare becomes increasingly digitized, building resilient and redundant systems is no longer optional. It is a fundamental requirement for ensuring patient safety and maintaining the integrity of care delivery. All stakeholders – healthcare providers, telecom companies, and technology vendors – have a responsibility to contribute to a more reliable and robust infrastructure.
