[cordite]

Downtime procedures are definitely a thing in the US. Known downtime is certainly the best time to prepare and practice, this happens when an EMR goes through an upgrade and migrations are run. This can be 6-24 hours.

There are bundled minor upgrades (think service packs) that have short (10-60 minute) downtimes, blocking migrations run in that time but are kept to a minimum. If it is at all possible, migrations will be async (even on major upgrades) and run in the background after the new version goes live.

During downtime, bloodwork and the like involve pre-allocated barcode labels. Either the results will be accessible on the instrument afterwards in its memory, or the results will be printed out and it is up to the lab tech to transcribe the results.

I can't speak in depth for radiology, but I expect that they have file share servers involved for the raw results. Likely less local memory (in number of results that can be stored) than clinical lab instruments.