The Red Cross Red Crescent Health Information System (RCHIS) is an electronic medical record (EHR) and health information management system (HIS) which has been designed for international disaster responses with a cloud-based server and a local server to bridge temporary internet outages. This architecture allows for remote information management and operational support should data processing agreements allows it.

Describe adapting a cloud-based health information system to a fully offline setting and improve business continuity in case of a system failure.

An analysis of the existing architecture of RCHIS was conducted to identify components and procedures that only work on the cloud-based server with an existing internet connection. Offline alternatives were identified and developed to ensure full offline operational capacity and redundancy.

A mechanism to set up a second local server for redundancy improves business continuity planning, and having locally stored backup allows the recovery of data without an internet connection. Instead of creating new user accounts in the cloud and emailing a one-time password (OTP), a mechanism to create accounts on the local server and display the OTP was added. The offline generation of the WHO EMT MDS report was embedded.

Adding the capability to work fully offline to RCHIS meant significant software architecture changes. Despite losing some of the benefits, such as remote information management, RCHIS is now a robust offline tool for deployment in settings without any internet connectivity. Having a local server also means that we can comply with data sovereignty rules where they exist.