Though ICANotes strives to maintain near 100% uptime for all services, it is important for each practice to establish a local downtime contingency plan in case of:

 

• Local internet interruptions
• ICANotes server maintenance
• Regional cloud disruptions

Maintaining such a plan aligns with HIPAA’s "Emergency Mode Operation Plan" requirement, as outlined in 45 CFR §164.308(a)(7)(ii)(C).
For real-time updates about ICANotes availability, please visit our system status page:
 → https://icanotes.instatus.com/

 

ICANotes Infrastructure & Redundancy

 

• Our primary application, https://ehr.icanotes.com, is replicated across multiple availability zones.
• Even during scheduled nightly maintenance, most users will remain in a read-only state able to access and review patient charts and notes.
• A read-only state may also be triggered during unscheduled maintenance or recovery events tied to your organization’s data volume. ICANotes will restore access as quickly as possible and will contact your account owner if any data is impacted.

 

Recommended Downtime Best Practices

1. Use the Upload Site for Read-Only Access

In the event that ehr.icanotes.com is unavailable or in read-only mode:
Go to: https://upload.icanotes.com

 

• You can view and download previously generated documents, including notes and reports.
• If your organization uses calendar snapshots, they may be accessible through this site.
• If the upload site is also unavailable, this likely indicates a broader service region disruption.

 

2. Print Your Daily Schedule

We recommend printing a copy of your next day’s calendar each evening as part of your standard operations.

 

• Legacy Calendar instructions: KB article – Printing Daily Schedule (Legacy)
• New Calendar instructions: KB article – Printing Daily Schedule (New)

 

This ensures that patient visits can proceed even if the system is down.

 

3. Keep Prescription Pads Handy

If you are unable to access electronic prescribing, maintain a secure, compliant paper prescription pad on-site as a fallback method.

 

4. Using DrFirst Outside of ICANotes

If ehr.icanotes.com is down, and you still have internet access, you may log in to DrFirst directly:

 

• Accessing the DrFirst web portal is possible, but:
  • Changes made outside of ICANotes will not sync automatically
  • You must manually document any medication changes in ICANotes once access is restored
• DrFirst login credentials are separate and must be obtained by phone via ICANotes Support
• Administrators: Avoid making changes in the Account Management section of DrFirst, as you are responsible for billing and access actions taken there

Call ICANotes Support at 443-569-8778 to request DrFirst access credentials. For security reasons, this information cannot be shared via email or ticket.

 

Summary
While https://ehr.icanotes.com is architected for high availability and resilience, preparation on the client side is a key part of HIPAA-compliant operations.

Backup Tools to Include in Your Downtime Plan:

 

• Access to https://upload.icanotes.com for reviewing patient notes
• Printed copy of the daily schedule
• Manual prescription pads
• DrFirst credentials for emergency prescribing (when appropriate)
• Monitoring the status page: https://icanotes.instatus.com

For guidance on implementing a downtime plan, or if you are experiencing an outage, please contact ICANotes Support at 443-569-8778.