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Continuing Anesthesia Services in the Face of a Prolonged Digital Health System Outage. In today's digitized healthcare environment, electronic health records (EHRs) and other electronic systems are key to daily hospital operations, patient care, and compliance. The authors' institution underwent a prolonged EHR system outage that caused the Department of Pediatric Anesthesiology to rely on established downtime procedures. While the intraoperative EHR is lost, this is only one of many domains that can be affected by an outage. In fact, all aspects of care, from patient identification materials to operating room schedules to in-house communication, can be significantly affected. Anesthesia providers must be ready to revert to preestablished downtime protocols to continue safe care while also maintaining financial sustainability. The following narrative review details the department's operational responses and outlines how safe and quality health care continued to be delivered, providing recommendations for other hospitals that may face similar challenges.