As the humanitarian crisis brought by Hurricane Harvey continues to unfold in Texas and Louisiana, health reporters are filing valuable stories on how hospitals in the region are holding up amid the devastating floods and displacement of thousands of residents.
Procedures and protocols put in place in Houston-area hospitals in recent years are being tested to the limit right now. Beyond hospital capabilities, displaced residents who fled rising waters in their homes are, in some cases, telling journalists they are without needed medications.
Access to medical records, prescription refills, health insurance information and other personal health data will be crucial in the coming days, weeks and months.
After Hurricanes Katrina and Sandy, many hospitals and physician groups were caught flat-footed without necessary back up systems. (Less than a quarter of physicians used an EHR when Katrina hit in 2005 and many paper-based patient records were lost in the storm.)
But hospitals also showed remarkable capabilities. I travelled as a reporter to Mississippi in fall 2005 and found that hospitals were vital centers for displaced residents months after the initial hurricane subsided. Many hospital staff members I interviewed lost their own homes and they continued to show up for work and deliver life-saving care.
So how prepared are U.S. hospitals today? A newly released survey by Hospitals & Health Networks magazine indicates that hospitals have advanced in in their abilities to withstand emergencies and retrieve vital information within hours.
The survey of American Hospital Association members, for the first time, included detailed questions on how quickly data could be restored in the event of a disaster that causes the complete loss of a primary data system. Of those hospitals responding to the survey, 49 percent said clinical information systems such as the EHR, laboratory and radiology would available within four hours.
Cloud-based computing has made total data loss less likely because information is stored offsite. Seventy percent of survey respondents said they have backup, cloud-based services for clinical data, an increase from 49 percent of survey respondents in 2015.
A lot of work remains to keep hospitals, patients and patient data safe when disaster strikes. Questions reporters can ask local hospitals about their disaster preparedness include:
- What communications equipment is available in the event of an emergency? (examples: mobile, fixed phone, satellite phone, ham radio, federal wireless or other telecom services and crisis communication platforms.) Experts say that mobile phone access is not sufficient during a crisis.
- Do you have an incident command center, and where is it located? What is the communication platform for the center that allows medical personnel in other locations to send and receive information?
- How often do you conduct emergency communications testing (monthly, quarterly, annually)?
- What data backup systems do you have in place for patient records, clinical systems, payroll, human resources and financial systems? How quickly can these systems be reinstated in the event of a disaster? (The goal is within four hours.)
- Are your data backup systems outside the immediate geographic area?
- Do you have mutual aid agreements with other area hospitals to coordinate services in the event of an emergency? (These agreements can make hospital transfers, supply sharing and evacuations happen more quickly.)
- When was your emergency preparedness plan with the city, county and other area hospitals updated? (The Joint Commission requires accredited hospitals to collaborate on emergency preparedness with local authorities and other area hospitals.)
- What is your evacuation plan? When was it last updated?
- How many days’ supplies do you have on hand in the event of a disaster? (e.g., food, medical supplies and medications).
- What telehealth services do you have available to patients in the event of a disaster (either on-site or via mobile devices)?
- Joint Commission Emergency Management Resources
- 10 years after Katrina: Progress and Challenges (2015)
- Hospital emergency preparedness and response during superstorm Sandy (HHS)
- HFM Emergency Management Survey (includes sources and questions to ask about preparedness.)
- Critical features of emergency power generators (2015)
- EMRs keep natural disasters from turning into personal care disasters
- Covering Harvey: Resources on hurricanes and natural disasters