{"id":"https://openalex.org/W3024582713","doi":"https://doi.org/10.1177/1460458220918539","title":"Understanding the scope of downtime threats: A scoping review of downtime-focused literature and news media","display_name":"Understanding the scope of downtime threats: A scoping review of downtime-focused literature and news media","publication_year":2020,"publication_date":"2020-05-14","ids":{"openalex":"https://openalex.org/W3024582713","doi":"https://doi.org/10.1177/1460458220918539","mag":"3024582713","pmid":"https://pubmed.ncbi.nlm.nih.gov/32403967"},"language":"en","primary_location":{"id":"doi:10.1177/1460458220918539","is_oa":true,"landing_page_url":"https://doi.org/10.1177/1460458220918539","pdf_url":"https://journals.sagepub.com/doi/pdf/10.1177/1460458220918539","source":{"id":"https://openalex.org/S201800618","display_name":"Health Informatics Journal","issn_l":"1460-4582","issn":["1460-4582","1741-2811"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Informatics Journal","raw_type":"journal-article"},"type":"review","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://journals.sagepub.com/doi/pdf/10.1177/1460458220918539","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5067855305","display_name":"Ethan Larsen","orcid":"https://orcid.org/0000-0001-6599-4577"},"institutions":[{"id":"https://openalex.org/I1295876152","display_name":"Houston Methodist","ror":"https://ror.org/027zt9171","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1295876152"]},{"id":"https://openalex.org/I1335321130","display_name":"Children's Hospital of Philadelphia","ror":"https://ror.org/01z7r7q48","country_code":"US","type":"funder","lineage":["https://openalex.org/I1335321130"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Ethan P Larsen","raw_affiliation_strings":["Houston Methodist Research Institute, USA; Children\u2019s Hospital of Philadelphia, USA","Children's Hospital of Philadelphia, USA"],"raw_orcid":"https://orcid.org/0000-0001-6599-4577","affiliations":[{"raw_affiliation_string":"Houston Methodist Research Institute, USA; Children\u2019s Hospital of Philadelphia, USA","institution_ids":["https://openalex.org/I1335321130","https://openalex.org/I1295876152"]},{"raw_affiliation_string":"Children's Hospital of Philadelphia, USA","institution_ids":["https://openalex.org/I1335321130"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5003762531","display_name":"Arjun H. Rao","orcid":"https://orcid.org/0000-0002-6682-6812"},"institutions":[{"id":"https://openalex.org/I91045830","display_name":"Texas A&M University","ror":"https://ror.org/01f5ytq51","country_code":"US","type":"education","lineage":["https://openalex.org/I91045830"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Arjun H Rao","raw_affiliation_strings":["Texas A&M University, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Texas A&M University, USA","institution_ids":["https://openalex.org/I91045830"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5005044797","display_name":"Farzan Sasangohar","orcid":"https://orcid.org/0000-0001-9962-5470"},"institutions":[{"id":"https://openalex.org/I1295876152","display_name":"Houston Methodist","ror":"https://ror.org/027zt9171","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1295876152"]},{"id":"https://openalex.org/I91045830","display_name":"Texas A&M University","ror":"https://ror.org/01f5ytq51","country_code":"US","type":"education","lineage":["https://openalex.org/I91045830"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Farzan Sasangohar","raw_affiliation_strings":["Texas A&M University, USA; Houston Methodist Research Institute, USA","Texas A&M University, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Texas A&M University, USA; Houston Methodist Research Institute, USA","institution_ids":["https://openalex.org/I1295876152","https://openalex.org/I91045830"]},{"raw_affiliation_string":"Texas A&M University, USA","institution_ids":["https://openalex.org/I91045830"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5067855305"],"corresponding_institution_ids":["https://openalex.org/I1295876152","https://openalex.org/I1335321130"],"apc_list":{"value":1500,"currency":"USD","value_usd":1500},"apc_paid":{"value":1500,"currency":"USD","value_usd":1500},"fwci":2.4708,"has_fulltext":false,"cited_by_count":19,"citation_normalized_percentile":{"value":0.91283481,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":89,"max":99},"biblio":{"volume":"26","issue":"4","first_page":"2660","last_page":"2672"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.9995999932289124,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.9995999932289124,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10508","display_name":"Patient Safety and Medication Errors","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/3604","display_name":"Emergency Medical Services"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13248","display_name":"Healthcare Technology and Patient Monitoring","score":0.9954000115394592,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/downtime","display_name":"Downtime","score":0.9836742877960205},{"id":"https://openalex.org/keywords/contingency-plan","display_name":"Contingency plan","score":0.6413908004760742},{"id":"https://openalex.org/keywords/contingency","display_name":"Contingency","score":0.4698822796344757},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.4477890133857727},{"id":"https://openalex.org/keywords/operations-management","display_name":"Operations management","score":0.42996734380722046},{"id":"https://openalex.org/keywords/business","display_name":"Business","score":0.4132801294326782},{"id":"https://openalex.org/keywords/health-care","display_name":"Health care","score":0.41019850969314575},{"id":"https://openalex.org/keywords/computer-security","display_name":"Computer security","score":0.2846206724643707},{"id":"https://openalex.org/keywords/engineering","display_name":"Engineering","score":0.19993487000465393},{"id":"https://openalex.org/keywords/economics","display_name":"Economics","score":0.10467645525932312}],"concepts":[{"id":"https://openalex.org/C180591934","wikidata":"https://www.wikidata.org/wiki/Q1253369","display_name":"Downtime","level":2,"score":0.9836742877960205},{"id":"https://openalex.org/C14331377","wikidata":"https://www.wikidata.org/wiki/Q2340208","display_name":"Contingency plan","level":2,"score":0.6413908004760742},{"id":"https://openalex.org/C97508593","wikidata":"https://www.wikidata.org/wiki/Q1359069","display_name":"Contingency","level":2,"score":0.4698822796344757},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.4477890133857727},{"id":"https://openalex.org/C21547014","wikidata":"https://www.wikidata.org/wiki/Q1423657","display_name":"Operations management","level":1,"score":0.42996734380722046},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.4132801294326782},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.41019850969314575},{"id":"https://openalex.org/C38652104","wikidata":"https://www.wikidata.org/wiki/Q3510521","display_name":"Computer security","level":1,"score":0.2846206724643707},{"id":"https://openalex.org/C127413603","wikidata":"https://www.wikidata.org/wiki/Q11023","display_name":"Engineering","level":0,"score":0.19993487000465393},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.10467645525932312},{"id":"https://openalex.org/C41895202","wikidata":"https://www.wikidata.org/wiki/Q8162","display_name":"Linguistics","level":1,"score":0.0},{"id":"https://openalex.org/C138885662","wikidata":"https://www.wikidata.org/wiki/Q5891","display_name":"Philosophy","level":0,"score":0.0},{"id":"https://openalex.org/C111919701","wikidata":"https://www.wikidata.org/wiki/Q9135","display_name":"Operating system","level":1,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D003695","descriptor_name":"Delivery of Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003695","descriptor_name":"Delivery of Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003695","descriptor_name":"Delivery of Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003695","descriptor_name":"Delivery of Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006268","descriptor_name":"Health Facilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006268","descriptor_name":"Health Facilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006268","descriptor_name":"Health Facilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006268","descriptor_name":"Health Facilities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006761","descriptor_name":"Hospitals","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006761","descriptor_name":"Hospitals","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006761","descriptor_name":"Hospitals","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006761","descriptor_name":"Hospitals","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D061214","descriptor_name":"Patient Safety","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D061214","descriptor_name":"Patient Safety","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D061214","descriptor_name":"Patient Safety","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D061214","descriptor_name":"Patient Safety","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1177/1460458220918539","is_oa":true,"landing_page_url":"https://doi.org/10.1177/1460458220918539","pdf_url":"https://journals.sagepub.com/doi/pdf/10.1177/1460458220918539","source":{"id":"https://openalex.org/S201800618","display_name":"Health Informatics Journal","issn_l":"1460-4582","issn":["1460-4582","1741-2811"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Informatics Journal","raw_type":"journal-article"},{"id":"pmid:32403967","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/32403967","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health informatics journal","raw_type":null},{"id":"pmh:oai:doaj.org/article:bf48fb1c2c4143beafde37a0f0250ca3","is_oa":true,"landing_page_url":"https://doaj.org/article/bf48fb1c2c4143beafde37a0f0250ca3","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Health Informatics Journal, Vol 26 (2020)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1177/1460458220918539","is_oa":true,"landing_page_url":"https://doi.org/10.1177/1460458220918539","pdf_url":"https://journals.sagepub.com/doi/pdf/10.1177/1460458220918539","source":{"id":"https://openalex.org/S201800618","display_name":"Health Informatics Journal","issn_l":"1460-4582","issn":["1460-4582","1741-2811"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Informatics Journal","raw_type":"journal-article"},"sustainable_development_goals":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":false},"content_urls":{"pdf":"https://content.openalex.org/works/W3024582713.pdf"},"referenced_works_count":21,"referenced_works":["https://openalex.org/W1599796661","https://openalex.org/W2015042083","https://openalex.org/W2020445042","https://openalex.org/W2023248478","https://openalex.org/W2030434108","https://openalex.org/W2103120311","https://openalex.org/W2128416007","https://openalex.org/W2150217040","https://openalex.org/W2156098321","https://openalex.org/W2185359233","https://openalex.org/W2218231226","https://openalex.org/W2314724448","https://openalex.org/W2515278805","https://openalex.org/W2617187239","https://openalex.org/W2783557465","https://openalex.org/W2891378911","https://openalex.org/W2894263735","https://openalex.org/W2969787208","https://openalex.org/W3024836541","https://openalex.org/W4242711478","https://openalex.org/W4247002863"],"related_works":["https://openalex.org/W2787048280","https://openalex.org/W2392230688","https://openalex.org/W2998451156","https://openalex.org/W77301593","https://openalex.org/W2091693299","https://openalex.org/W2034552653","https://openalex.org/W2324534994","https://openalex.org/W4302337977","https://openalex.org/W2387214795","https://openalex.org/W2076452472"],"abstract_inverted_index":{"Electronic":[0],"health":[1],"record":[2],"downtimes":[3],"are":[4,11,25],"any":[5],"period":[6],"where":[7],"the":[8,57,85,129,157,164,175],"computer":[9],"systems":[10],"unavailable,":[12],"either":[13],"for":[14,33,162,174],"planned":[15],"or":[16,43],"unexpected":[17,21],"events.":[18,69],"During":[19],"an":[20],"downtime,":[22],"healthcare":[23,34,78],"workers":[24],"rapidly":[26],"forced":[27],"to":[28,46,66,77,97],"use":[29],"rarely-practiced,":[30],"paper-based":[31],"methods":[32],"delivery.":[35],"In":[36],"some":[37,134],"instances,":[38],"patient":[39],"safety":[40],"is":[41,141],"compromised":[42],"data":[44],"exposed":[45],"parties":[47],"seeking":[48],"profit.":[49],"This":[50],"review":[51,83],"provides":[52],"a":[53,81,111,146,153],"foundational":[54],"perspective":[55],"of":[56,60,72,84,95,101,113,116,128,136,177],"current":[58],"state":[59],"downtime":[61,68,96,102,117,131,165],"readiness":[62],"as":[63],"organizations":[64],"prepare":[65],"handle":[67],"A":[70],"search":[71],"technical":[73],"news":[74],"media":[75],"related":[76],"informatics":[79],"and":[80,123],"scoping":[82],"research":[86,172],"literature":[87],"were":[88],"conducted.":[89],"Findings":[90],"ranged":[91],"from":[92],"theoretical":[93],"exploration":[94],"empirical":[98],"direct":[99],"comparison":[100],"versus":[103],"normal":[104],"operation.":[105],"Overall,":[106],"166":[107],"US":[108],"hospitals":[109],"experienced":[110],"total":[112],"701":[114],"days":[115],"in":[118],"43":[119],"events":[120,132],"between":[121],"2012":[122],"2018.":[124],"Almost":[125],"half":[126],"(48.8%)":[127],"published":[130],"involved":[133],"form":[135],"cyber-attacks.":[137],"Downtime":[138],"contingency":[139,178],"planning":[140],"still":[142],"predominantly":[143],"considered":[144],"through":[145],"top-down":[147],"organizational":[148],"focus.":[149],"We":[150],"propose":[151],"that":[152],"bottom-up":[154],"approach,":[155],"involving":[156],"front-line":[158],"clinical":[159],"staff":[160],"responsible":[161],"executing":[163],"procedure,":[166],"will":[167,180],"be":[168,181],"beneficial.":[169],"Significant":[170],"new":[171],"support":[173],"development":[176],"plans":[179],"needed.":[182]},"counts_by_year":[{"year":2026,"cited_by_count":2},{"year":2025,"cited_by_count":8},{"year":2024,"cited_by_count":1},{"year":2023,"cited_by_count":4},{"year":2022,"cited_by_count":3},{"year":2021,"cited_by_count":1}],"updated_date":"2026-05-22T06:13:13.366637","created_date":"2025-10-10T00:00:00"}