When a hospital's systems go down, care does not stop. It goes back to pen and paper, and the first sign is quiet, because the alerts stop. Physician and CISSP Mark Yoffe explains clinical compensating controls: the steps clinicians take to keep patients safe during downtime. He covers who owns the clinical workflow, how to make controls workable and tested, how to recover information lost in the "memory hole," and what leaders should demand as proof. Paper is not the same as proof. Your hosts are Kip Boyle, CISO with Cyber Risk Opportunities, and Jake Bernstein, Partner with K&L Gates.

 

LinkedIn: https://www.linkedin.com/in/mark-yoffe-md-cissp-a9927956/

 

"Fire Doesn't Innovate" by Kip Boyle: https://a.co/d/0bYatohy

 

 

LinkedIn post:

 

Questions:

Here are audience engagement questions for this episode, organized by segment:

 

Segment 1 – When the Hospital Goes Analog

  • Have you ever worked through a system outage — at a hospital or anywhere else? What was the first thing that broke down?
  • Does your organization have any setting where "no news is bad news" during downtime — where information stops coming to you and you don't immediately notice?

Segment 2 – Ownership

  • Who owns your clinical downtime workflow right now — not IT, but the clinical side? Can you name them?
  • If your systems went down tonight, is there a single person accountable for whether patient care workflows hold up — or would people be figuring it out as they go?

Segment 3 – Workability

  • Does your downtime policy actually get used, or does it live in a binder somewhere? When did anyone last open it?
  • What's one task your team assumes staff can improvise during downtime — that they probably can't?

Segment 4 – The Memory Hole

  • After your last outage, how confident are you that everything documented on paper actually made it into the record? Did anyone check?
  • Has a gap in documentation during downtime ever affected a patient's care — or nearly did?

Segment 5 – Leadership Oversight

  • If your CEO asked today, "Can you show me that our clinical downtime controls actually work?" — what would you hand them?
  • When did your organization last run a tabletop exercise specifically for clinical downtime — not just IT recovery?

Closing poll question:

Does your organization have a named, clinically credible owner for downtime workflows — yes, no, or "I genuinely don't know"?


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