The short answer. A MEDITECH hospital has four places to look for downtime coverage: MEDITECH’s own High Availability SnapShot, downtime products built for MEDITECH by third parties such as Acmeware and iPeople, hosting and disaster-recovery partners such as CloudWave and CereCore, and an EHR-independent continuity system. The first three are good at showing recent data and restoring systems. What to check is whether your clinicians can keep documenting care, on infrastructure an attacker can’t reach, for the length of a real outage.
MEDITECH isn’t a niche platform. KLAS puts it at 14.7% of US hospitals in its 2025 market share data, and HCA had 72 hospitals live on Expanse by August 2026 (Health System CIO, citing KLAS, September 2026). A large share of those hospitals run lean IT teams, and that matters here: whatever downtime option you choose, the team that has to activate it at 3 a.m. is small.
Why this decision matters more in 2026
Outages are longer than downtime plans assume. Microsoft’s 2025 rural health cybersecurity report put average downtime after a hospital ransomware attack at 18.7 days, at an estimated $1.9 million per day. The same report found that 69% of the rural hospitals it assessed hadn’t implemented multifactor authentication (Microsoft, 2025). Paper procedures written for an eight-hour server failure won’t hold for three weeks.
Attackers also go after recovery tools first. In Sophos’s 2024 survey of 402 healthcare organizations hit by ransomware, attackers tried to compromise backups in 95% of cases and succeeded in 66% (Sophos, 2024). Any downtime option that shares your domain or your credentials is exposed to the same attack.
The four options open to a MEDITECH hospital
1
MEDITECH High Availability SnapShot
MEDITECH describes High Availability SnapShot as cloud-based backup protection that gives Expanse customers browser access to critical patient data during downtime, from any device (MEDITECH). It’s the natural first layer for an Expanse hospital because it comes from the EHR vendor. MEDITECH’s public material doesn’t say how often the snapshot refreshes or whether clinicians can document in it, so ask both questions directly.
2
MEDITECH-specific downtime products
Third-party vendors build downtime tools specifically for MEDITECH environments. Acmeware markets Downtime Defender as a MEDITECH business continuity product, and iPeople sells an offline and downtime product suite for MEDITECH (Acmeware; iPeople). Both are MEDITECH-listed vendors. Ask where each one runs during an event, how clinicians sign in, and whether it covers documentation or only viewing.
3
Hosting and disaster-recovery partners
Managed hosting providers such as CloudWave (OpSus Healthcare Cloud) and CereCore offer managed backup and disaster recovery for MEDITECH hospitals (CloudWave; CereCore). Disaster recovery restores systems. It answers “how fast can we come back,” measured in hours or days. It doesn’t keep clinicians working while the restore runs, so it belongs in the plan next to a continuity option, not in place of one.
3
An EHR-independent continuity system
The fourth option runs outside the MEDITECH stack entirely: a separate clinical workspace fed continuously from the EHR, hosted by a different company, with its own sign-in. During an outage clinicians keep working in it. After recovery, the records created during downtime go back to the EHR.
| Option | Main job | Clinicians document during outage? | Sits outside the hospital domain? |
|---|---|---|---|
| High Availability SnapShot | View recent patient data | Confirm with MEDITECH | Hosted in the cloud; confirm how clinicians sign in |
| MEDITECH-specific downtime products | Viewing and printing during downtime | Varies by product | Varies by deployment |
| Hosting and DR partners | Restore systems | No, until restored | Varies by contract |
| Separate continuity system | Keep care moving during the outage | Yes | Yes, by design |
Six questions for any MEDITECH downtime vendor
- How current is the data at the moment the outage starts? A continuous feed and a nightly snapshot give very different answers on day one.
- Who hosts it, and does it share our cloud tenant? Different infrastructure owner, different blast radius.
- What credentials do clinicians use during an event? If it’s hospital Active Directory, a domain compromise reaches it.
- Can nurses document care and verify medications in it? Viewing covers a shift. Documenting covers a three-week outage.
- How do downtime records get back into Expanse? Paper reconciliation takes staff hours your team won’t have.
- Can we test it during planned maintenance? If you can’t prove it on a scheduled window, you’re finding out during an attack.
Where Spare Tire fits for MEDITECH hospitals
Spare Tire is an EHR-independent continuity system, option four above. It connects to MEDITECH Expanse through HL7, the same way it connects to Epic, Oracle Health (Cerner) and other HL7-capable EHRs, so there’s nothing to rip out and no change to your hosting or DR contract. It runs on an external cloud with separate credentials, which keeps it outside the reach of a compromised hospital domain.
During an outage, clinicians use it to review charts, document care, place orders and verify medications. When Expanse comes back, the records can be validated before they’re written back, and conflicts come up as exceptions for clinical review instead of overwriting data silently.
It’s designed to sit next to High Availability SnapShot and your DR partner, not replace them. The snapshot shows what was in the chart. The DR partner restores the system. Spare Tire keeps the unit running in between. For hospitals with small IT teams, the practical test is a planned maintenance window: turn it on, time the activation, and let a unit work a shift in it.
Frequently asked questions
Does MEDITECH have a built-in downtime solution?
Yes. MEDITECH offers High Availability SnapShot, which it describes as giving Expanse customers browser access to critical patient data during downtime. Many MEDITECH hospitals add a third-party downtime product or a DR partner on top, and some add a separate continuity system.
Can a MEDITECH hospital use a downtime solution that also works with Epic?
Yes, if the product integrates through HL7 rather than a MEDITECH-only method. That matters for health systems running more than one EHR after acquisitions.
What's the difference between MEDITECH disaster recovery and downtime continuity?
Disaster recovery restores MEDITECH systems after they fail. Continuity keeps clinicians working while that restore is still running, which Microsoft’s 2025 data suggests averages 18.7 days after a ransomware attack.