8 key steps to take to prepare for a natural disaster
More than ever, healthcare IT executives must be prepared for interruptions in service that take electronic health records and other information systems offline. But sometimes, natural disasters pose threats that complicate even basic healthcare delivery, and IT interruptions can exacerbate both care delivery and overall recovery of operations. Hospitals must have plans for catastrophic failures, such as the 2011 tornado that destroyed Mercy Hospital in Joplin, Mo. Here, the organization shares its experiences in recovering IT and basic operations.
Natural disaster devastates Mercy
Mercy Hospital experienced one of the ultimate disasters on May 22, 2011, when the facility was incapacitated by an EF5 tornado. The facility took a direct hit—its roof was pulled off, windows and walls were blown out causing significant internal damage to the structure of the building, and on-site emergency generators were destroyed. A complete loss of communication immediately disrupted patient care.
Alternative sites suffer massive damage
The tornado also profoundly affected alternative sites for care. Some 86 medical staff offices were destroyed or severely damaged, and the medical office building on campus was heavily damaged. Some 183 patients were in the facility at the time and quickly evacuated. The organization set up two alternative care sites in undamaged sections of the city, one of which was operational within 48 hours.

Because Mercy was far along in its use of information systems for patient care, the immediate shutdown of systems caused by the storm imposed profoundly impacted patient care and essential exchanges of information. The hospital received immediate support in its recovery from parent company Mercy, the seventh largest Catholic health system in the U.S.
Lesson 1: Make sure EHR information isn’t trapped onsite
EHRs enable providers to electronically compile health information that previously would have been stored on paper. However, catastrophic interruption of power or network services means crucial information may be inaccessible. Providers typically have backup plans with offsite data centers. The Mercy system implemented its EHR from Epic Systems in 2006 and virtualized data storage with NetApp. In 2009, it invested $60 million in a new data center to support the virtualized infrastructure; it went online in 2011 before the tornado.
Lesson 2: Enable access to cloud-based information
The fact that its data center was brought online before the Joplin disaster was a godsend, said Scott Richert, vice president of enterprise services. “The biggest factor for us was that we had moved patient data out of the basement and into the cloud,” he said. Mercy had migrated patient data from Mercy Joplin, which previously had kept it onsite. “Had we not taken that step, the results would have been completely different.”
Lesson 3: Get information to new locations
Because of the extensive destruction in Joplin, Mercy had to have a flexible approach in re-establishing access to patient data to emergency care sites. In addition, some patients were transported to other Mercy hospitals in the area, and the virtualized approach for storing data also proved useful in distributing patient information to those new care sites.
Lesson 4: Acknowledge the importance of IT staff in emergency situations
Richert underscored the critical role IT staff played in restoring services, highlighting the importance of training, establishing a strong team spirit and helping members realize their critical role in continuity of care. “Along with being prepared from a technology perspective, the people made a huge difference,” he said. “A lot was following procedures to get IT back online, but there was a whole lot of improvising, too, depending on the situation on the ground. We had an IT team turn a hotel conference room into a call center and a school gymnasium into a physician center.”
Lesson 5: Reach out to your vendors for support
Strong vendor relationships are critical in disaster recovery, Richert said. “Our vendors and partners really came through for us,” he said, indicating that a wide range of suppliers sprang into action when the disaster hit. “They were donating equipment we needed; one brought an RV to the site just so we would have a place for a conference room.” The system took advantage of its extensive supply chain, borrowing equipment, telecommunications devices and more. Sprint and AT&T erected satellite dishes to ensure access to data from new care sites.
Lesson 6: Have a worst-case disaster plan
Having a single fail-safe plan, even if it looks bulletproof, isn’t enough, Richert said. “Just having a data center for backup isn’t sufficient,” he said. “When you do business continuity planning, you have to take into account everything. What if it’s a partial failure, like if a rack or row of servers is damaged and inoperable? Can you break that infrastructure out and still continue to operate?”
Lesson 7: Anticipate massive disruptions in communication
Person-to-person communication grows in importance during a disaster, and locally, immediate communication among hospital staff was handled through texting and social media. Because of the devastation, it was important to rig alternative lines for communication, which Richert helped restore during a week-long stay in Joplin.
Lesson 8: Don’t underestimate the human toll on IT staff
Finally, IT executives need to show care and concern for their staff. Disasters often mean long, grueling hours of work over several days, but employees are often dealing with their own sense of loss or of simply not knowing their own life situations. “Co-workers were dealing with their own homes being hit, and you need to be aware of that. Our system’s CEO and his wife came down to help, and he assured them to let him know what they needed. There was engagement, and it was pretty touching to see.”
Thanks to Mercy Hospital for sharing its experience with recovering from the May 2011 tornado. A more extensive presentation on the wide array of lessons learned  is available here.

Information on Virtualized Storage:
Additional help for this topic was provided by NetApp. Information on some of the technology employed by Mercy Hospital is available here.