Microsoft Outage: How Technology Disruptions Can Affect Nurses

The massive Microsoft outage that began on November 12, 2026, left users without access to Outlook, Copilot, and other workplace tools.

For those working in healthcare, losing digital communication systems can be more than an inconvenience. Healthcare increasingly depends on technology to coordinate care, communicate with colleagues, access resources, and manage daily operations.

Paige Shoop, MSN, RN, CNOR, a nurse manager who worked during the outage, experienced those challenges firsthand.

“The Microsoft outage disrupted my normal workflow, particularly communication and meeting accessibility,” said Shoop. “I was unable to send or receive emails or access Zoom meetings directly through my computer calendar.”

For Shoop, those tools are an important part of managing daily operations.

“As a nurse manager, much of my day involves coordinating with staff, providers, and other departments, so losing access to these tools created some challenges in managing daily responsibilities,” she said.

Her experience highlights a larger issue for healthcare: Even when EHRs remain operational, losing other technology can disrupt the systems surrounding patient care.

The disruption also wasn’t healthcare’s first experience with widespread Microsoft-related disruptions. In July 2024, a faulty CrowdStrike software update affecting Microsoft Windows systems disrupted hospitals across the country, forcing some nurses to switch to paper documentation and contributing to canceled procedures, ambulance diversions, and other interruptions to patient care. The incident highlighted many of the same concerns about healthcare’s growing dependence on interconnected technology.

What happened during the Microsoft outage?

The Microsoft outage began November 12, 2026, with users reporting problems accessing Exchange Online mailboxes, Outlook, Copilot applications, and some Microsoft Teams.

Microsoft initially reported elevated infrastructure load across multiple regions. The company later said a number of servers had unexpectedly become unavailable, increasing strain on the remaining infrastructure. Microsoft paused deployments and configuration changes, restarted affected servers, and redirected traffic while working to restore services.

According to reporting from Yahoo Newsmore than 97,000 Outlook incident reports occurred around 2:07 p.m. Eastern time, and more than 38,000 Microsoft 365 reports, as well as approximately 4,500 reports involving Teams. Other reports placed Outlook complaints at nearly 130,000 around the height of the disruption.

Microsoft reported potential problems with Exchange Online, Teams, SharePoint Online, Microsoft 365 Copilot and several other services.

There was no indication at the time that the outage resulted from a cyberattack.

Why a Microsoft outage matters

The Microsoft outage wasn’t a nationwide EHR failure. However, the disruption still affected healthcare operations.

KCRG reported that University of Iowa Health Care experienced problems with email and voicemail, while healthcare organizations in other countries reported similar administrative and communication challenges.

Even when clinical systems remain available, disruptions to everyday communication tools can complicate healthcare workflows. Patient care continues regardless of whether email or another digital platform is working. Nurses still need to complete assessments, administer medications, and coordinate admissions and discharges. Providers need updates, lab results require follow-up, and nurse managers need to communicate with staff and other departments.

When a familiar communication tool suddenly becomes unavailable, these routine responsibilities may require additional steps, alternative communication methods, and more time to complete.

Communication disruptions create additional challenges

Communication is a foundation of safe healthcare. The World Health Organization identifies communication breakdowns and health information technology issues among factors that can contribute to patient harm. The Joint Commission has also emphasized the importance of effective handoffs and reliable communication of patient information.

Shoop said the Microsoft outage created communication delays during her workday.

“The inability to send or receive emails created communication delays, particularly when coordinating with other departments and addressing time-sensitive operational needs,” she said.

Without email, sharing updates and following up on outstanding requests became more difficult.

“We had to rely more heavily on alternative communication methods to maintain continuity throughout the day,” Shoop said.

Tina Lipscomb, MSN, RN, CCM, a manager of case management from North Carolina, faced similar challenges while coordinating time-sensitive work across multiple sites and teams.

“Yesterday’s outage was a real reminder of how dependent we have become on email, Zoom, Word, and Copilot to communicate and coordinate work across multiple sites and teams,” Lipscomb said. “When those tools were unavailable, we had to quickly rethink how we communicated and accomplished time-sensitive work.”

For Lipscomb, that meant turning to more traditional forms of communication. Text messages and phone calls became the primary way to stay connected, and when her team couldn’t schedule a new Zoom meeting for a critical situation, they brought the necessary people together in person.

That doesn’t mean an email outage automatically threatens patient safety. However, communication disruptions can create additional opportunities for delays, confusion, or missed information.

Technology workarounds add to the workload

When technology stops working, nurses and other healthcare professionals often have to find another way to complete routine tasks.

A message that would normally take seconds to send electronically may require a phone call. A resource stored online may need to be located somewhere else. A scheduled meeting may suddenly require another device or platform.

Those types of workarounds can help minimize disruption, but they also illustrate the extra steps healthcare professionals may face when technology becomes unavailable.

Lipscomb had to find a workaround when she needed to prepare a complex case presentation without access to Word or Copilot. She drafted it on her phone and shared it by text.

Research has found that problems with electronic health records and related workflows can increase nurses’ cognitive burden. Studies of EHR downtime have also identified potential problems involving medications, laboratory processes, imaging, patient identification, handoffs, and documentation.

The Microsoft outage was different from a complete EHR failure, but the broader lesson is similar: Healthcare organizations need to prepare for technology disruptions before they happen.

Downtime planning needs to extend beyond the EHR

Healthcare workers may associate “downtime” primarily with the EHR going offline, but contingency planning should account for other critical systems.

The Agency for Healthcare Research and Quality noted that health information technology downtime can result from software or hardware failures, internet problems, cyberattacksnatural disasters, and other disruptions.

Healthcare organizations should consider what happens when email, Teams, shared documents, authentication systems, or other commonly used tools become unavailable.

Shoop said there wasn’t a formal downtime process specifically for this outage, but alternative technology allowed her to maintain communication.

“The experience reinforced the importance of having multiple communication options available, particularly in healthcare leadership, where timely communication is essential to daily operations,” she said.

Healthcare is becoming increasingly dependent on interconnected technology, so it’s up to organizations to recognize the additional workload outages can place on nurses and other staff rather than relying on staff to improvise solutions. Both Lipscomb’s and Shoop’s experiences demonstrate the value of having alternative options in place to maintain essential operations and support staff during unexpected disruptions.