Two is One, One is None

With such fantastic medical educational content being produced on the web everyday, the EM community may have been lulled into a sense of  internet permanence.  For example, I’m sure many of us have said or heard others say:

“Just back it up online”. “Just search for it on Twitter”.  “Google owns Blogger, it isn’t going anywhere”.  “The wordpress blog won’t crash”.  “I can always redownload the podcasts I heard last year.  “I’ll just repost everything if it gets deleted”. “I’ll google the show notes later as a reference”.  “I have everything on Dropbox and Evernote”.

At the end of the day, just as everything offline is transient, everything online is especially transient.  Many of the posts, conversations and educational materials that we are hosting on free services provided by advertising companies could vanish overnight.  If we are not paying for the product we are the product.  If you get a service for free, there is no guarantee that the service will be there tomorrow.

Also, no company has to provide an easy way to export your content if they all of a sudden decide to shut down. How would you feel if Evernote or Dropbox lose your data tonight?  Most hosting providers of blogs are not backing up your posts for you unless you have specifically set up a backup plan.  Even then most backups will be stored in the same place as your original.  Taking it one step further, most online services are using the same storage providers (mainly Amazon for consumer services) and if there is a large failure your blog and twitter may disappear at the same time.

Just as an example, we at the OpenEM Foundation host on Amazon Web Services as well as backups on other AWS data centers that are not hosting the main site.  We also have have offline copies and offsite copies of those offline copies.   The site suffered a downtime this year and all of our backup strategies pulled through.  The content that all of us write online is important for long term education of our specialty and we should always be thinking about ways to protect it.

We encourage all contributors to the online medical community to take time to assess their backup strategy, attempt a restore to make sure it works before the failure occurs, and follow the military maxim that we all follow in the ED: “One is none, Two is One.”

We always practice with a backup airway, backup technique, and backup physician and we should treat our educational content the same way.

If anyone needs help setting up or testing a backup solution for their content or wants to explore options and solutions, send an email to

Update 1: There has been a lot of discussion regarding the ideal backup solution.  While impossible to describe every option here, the process should be automatic.  Introducing a manual component is acceptable for the 3rd or 4th backup copy but the primary backup should not be subject to human fallibility.  For WordPress, vaultpress plugin is a possible good option.  For wikis the process is more difficult.

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