As Hurricane Irma bears down on Florida hospitals, Houston providers that weathered the effects of Hurricane Harvey just two weeks ago are offering some of the lessons learned and best practices that got them through that storm.
These days, Lucky Chopra is feeling as his name says—lucky—given that so many of Houston’s medical facilities have been ravaged by flooding in the wake of Hurricane Harvey.
As CEO of Advanced Diagnostics Healthcare, the parent company which manages an acute care surgical hospital in East Houston that did not flood and remained open, Chopra credits leveraging cloud-based technology from healthcare IT vendor athenahealth for enabling the facility to remain operational.
“We did not flood—we think that’s partially by design—and we stayed up during the entire storm,” says Chopra, referring to Advanced Diagnostics Hospital East Houston, which consists of four operating rooms, two special procedure rooms, four inpatient rooms and four full-size extended recovery rooms.
He contends that athenahealth’s network-enabled services “ran mission-critical operations for us that did not fail, taking the burden off of us in not having to worry about those systems while we had plenty of other worries.”
Chopra, who has lived through Hurricane Ike in 2008 and Tropical Storm Allison in 2001, notes that the “real preparations for these storms” take place even before the establishment of a facility, when providers select the right vendors to partner with—and even during site selection. “Athenahealth had assured us that they would support us, and we banked on that,” he says.
Rob Turner, CEO of Advanced Diagnostics Hospitals & Clinics, adds that the hospital in East Houston transitioned last year from an on-premise electronic health record from MEDITECH to a hosted EHR solution from athenahealth, which he believes made all the difference during the storm. “Athenahealth stayed up the entire time which was crucial,” observes Turner.
He adds that, in preparation for Hurricane Harvey, the hospital went through contingency planning, including making sure there were sufficient supplies of food as well as fuel for backup generators—all steps now required by the Centers for Medicare and Medicaid Services.
Last September, CMS issued a final rule requiring healthcare facilities to conduct risk assessments using an all-hazards approach, as well as develop emergency preparedness plans, policies and procedures—including distinct communications plans—and establish training and testing programs. In addition, hospitals, critical access hospitals and long-term care facilities must have emergency and standby power systems that reflect their emergency plans, according to the agency.
“Our hospital was not flooded, but a tertiary care hospital owned by HCA which is just across the freeway and down about a hundred yards—called East Houston Regional Medical Center—had about 12 feet of water,” says Chopra, who notes that his facility is taking on some of the patients of the nearby flooded hospital.
On August 25, East Houston Regional Medical Center made the decision to temporarily suspend service for patient safety reasons as well to consolidate resources in preparation of Hurricane Harvey. The center subsequently announced that it will suspend services until further notice for the safety of patients, physicians and staff.
“East Houston Regional Medical Center is in an area prone to flooding and was evacuated before Harvey,” says Debra Burbridge, a spokeswoman for HCA Healthcare Gulf Coast Division. “Remediation is underway.”
In anticipation of Irma, several Florida hospitals in the Keys and Miami have already closed their doors and evacuated patients to other medical facilities. It’s a weighty decision for these facilities in light of the difficult logistics of transferring patients to different care sites—some outside of their own health systems.
Geography and location are often the most significant factors in that decision-making process, according to Turner. “We have the good fortune of being on one side of the bayou that is more uphill than (East Houston Regional Medical Center),” says Turner. “We saw other larger health systems closing around us. Every other hospital that was east of downtown made the decision to shut down.”
As a result, he relates that Advanced Diagnostics Hospital East Houston saw an influx of patients both in the emergency department as well as inpatient volumes. “We have stepped up as a resource for the community,” adds Chopra.
Dan Jenson, CFO of VillageMD Houston, a primary care practice that includes 11 clinics and more than 100 physicians, says they relied on athenahealth’s cloud-based technology to stay in contact with their patients providing them with connectivity to providers and medical services during Hurricane Harvey.
Jenson relates that athenahealth “was able to build—practically overnight—a solution for us to reach out to more than 150,000 of our patients and send them text messages, phone calls and emails” that included critical contact information and updates about VillageMD’s operations. VillageMD uses the athenaCommunicator tool to provide automated communication services for sending clinically relevant messages to its patients.
“Knowing who to contact and feeling that they were not alone was very comforting to them,” says Jenson.
In addition, the primary care practice was able to focus on high-risk patients and those with special needs to ensure they were able to mitigate any disruptions to care. VillageMD was able to treat some patients over the phone and to even order X-rays in situations where patients could not get to a clinic.
According to Jenson, because athenahealth’s EHR is integrated across all its clinics, clinicians were able to triage patients over the phone regardless of who their primary care physicians were and their location.
“We had physicians that were on call throughout the storm, and one of the great things about athenahealth being cloud-based is that they were able to access those medical records through laptops,” adds Jenson, who says the EHR also works well on tablets and smartphones. “Physicians that even lost power at their homes were able to access athenahealth over the mobile app.”
Through a program called Village at Home, he notes that in the aftermath of Harvey, clinics will be able to send doctors armed with athenahealth’s mobile app to see patients in their homes to address health issues arising from flood damage and environmental factors.
“Having the ability to take some of these mobile EHR features out into the homes and community is a very special thing,” Jenson concludes.
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