Health IT

Disaster Preparedness and Health Information Exchanges

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HIEs are critical to weathering a storm.

Protecting, sharing and transferring health information is never more important than in the wake of a disaster, when waves of new victims flood health systems with damaged infrastructure.  As states develop and enhance Health Information Exchanges, our ability to adapt and respond to crises improves as well.

“Providers having access to patient health records is critical during a disaster,” according to Lee Stevens, policy director for State Health Information Exchanges in the Department of Health and Human Services.

It’s obvious that providers should tailor their disaster preparedness to their specific location, like flood protections in lower Manhattan or New Orleans, he said, but HIEs are essential to recovery after any disaster.

“Seemingly simple issues like allergies can have serious consequences when a provider isn’t aware,” Stevens told HealthBiz Decoded.  “Medication histories are also critically important as providers can quickly discern a patient’s health conditions based on prescribed medications.”

HIEs – online data networks that connect patients’ electronic health records from different health systems – were put to the test in natural disaster-ridden 2012.

Almost every U.S. market has simple exchanges already, but southern states have the most advanced systems, and most have interstate connectivity for secure messaging already, Stevens said. He wasn’t surprised to learn that electronic data was live following the May tornadoes in Oklahoma, a state with a long history of robust HIE development, he said.

A tornado leveled Moore Medical Center and two nearby physicians’ offices, but all patients were transferred to other facilities within the same Norman Regional Health System in the hours following the storm. The facilities had instant access to their patient health data, which was stored on two remote servers, resulting in minimal interruptions to care, according to reports.

“The scope of this disaster again illustrates the danger of paper-based systems,” Stevens said.  “Any paper records in the destroyed hospital or clinics are likely not recoverable in any meaningful way.” But electronic data backed up offsite was secure, he said.

The HIE helped local facilities take on the Moore Medical patients while caring for more than 130 other victims of the tornadoes. The 15 physicians also displaced from their practices at damaged offices viewed their patients’ records on their virtual desktops when they logged on from stable facilities. “Virtual desktopsstore your icons, documents, toolbars and widgets on a remote server instead of being tied to a single device.

To emulate the systems in Oklahoma, Stevens said providers should

  • Mitigate risks within the office (like flooding).
  • Have access to all patient records electronically.
  • Back up the data through an HIE or at an offsite location.
  • Have a plan to access that data in the event they must suddenly change location or transfer patients to a triage center or hospital.

The next important step beyond HIE implementation is for patients to have access to their own data, as was the case when hurricane Sandy struck New York in October of last year.

“Consumers aggregating and having access to their own data is the ultimate back-up plan during a disaster,” Stevens said.  “State wide networks like the State Health Information Network-New York (SHIN-NY) have proven to perform during disasters.”

SHIN-NY, an information network transmitted between users, was operational throughout Hurricane Sandy with millions of patient records available at points of care, he said.

It’s important for consumers to get Personal Health Records in a network like SHIN-NY, familiarize themselves with the system, and check in to make sure all of their providers are sharing their data, he said. Patients with chronic or complex diseases especially need access to their data from any Internet-connected device, including smartphones, he said.

Natural disasters actually create new data, too.

“With each disaster we learn more and, most importantly, we see the critical need for patient’s to take some level of responsibility (if they are able) for having access to their records electronically,” Stevens said.  “No system can be perfect but we get closer to achieving that with experiences from each disaster, especially with redundant avenues for access.”

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