Electronic Health Records Rise Above Harvey’s Floodwaters

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By James Swann

Unprecedented flooding from Hurricane Harvey has devastated much of the Houston area, but the health system so far is holding up with the help of robust adoption and use of electronic health records.

The vast majority of all providers in the greater Houston area use EHRs, and the service is working well to support displaced patients and providers during the ongoing crisis, Nick Bonvino, chief executive officer of Greater Houston Healthconnect, told Bloomberg BNA. GHH is the health information exchange for southeast Texas and is responsible for coordinating the electronic transmission of medical records among all health-care providers in the region.

The widespread adoption of EHRs is especially important when hospitals are evacuating patients to different providers, Bonvino said, allowing providers to see information on new patients, such as allergies, active medications, and even diagnostic images. St. Luke’s Hospital and Bayshore Medical Center have already been forced to evacuate patients due to rising flood waters.

Twelve out of 13 state-supported living centers throughout Texas transitioned to a new EHR system last year, which helped make the evacuation of over 200 residents from the Corpus Christi SSLC relatively seamless, Christine Mann, a press officer with the Texas Health & Human Services Commission, told Bloomberg BNA.

SSLCs take care of roughly 3,000 individuals with intellectual and developmental disabilities who are medically fragile or who have behavioral issues.

Prior to the new EHR system, residents who moved out were accompanied by paper files, Mann said. By using an EHR system, medical history records and prescription information were immediately available for patients evacuated to the San Antonio SSLC, Mann said.

The new EHR system for the SSLCs was implemented by the Texas Department of Aging and Disability Services and is known as the Integrated Resident Information System.

Overall, 71 percent of Texas physicians were using an EHR as of 2016, Brent Annear, a spokesman for the Texas Medical Association, told Bloomberg BNA.

The push for a nationwide, interoperable network of EHRs began in 2005 after Hurricane Katrina, which destroyed countless paper medical records. Shortly after Katrina hit New Orleans, then-Health and Human Services Secretary Michael Leavitt created a federal advisory committee to begin developing a national EHR system.

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 furthered the push for EHRs. Specifically, the HITECH Act created an incentive program for certain providers and hospitals that could demonstrate their meaningful use of EHRs.

The incentive program was open to critical access hospitals and most physicians, but didn’t include skilled nursing or long-term care facilities, or facilities such as SSLCs.

Information Exchange

Healthcare Access San Antonio (HASA), a regional health information exchange serving San Antonio, Corpus Christi, and the Dallas-Fort Worth area, has also taken steps to help bolster the health-care system and improve electronic transmission of patient data during the current crisis.

“We initiated a special arrangement with our counterpart in Houston, the GHH, to make information exchange possible and assist providers in dealing with the current hurricane crisis,” Gijs van Oort, chief executive officer of HASA, told Bloomberg BNA.

Prior to the hurricane’s landfall, HASA and GHH reviewed their respective capabilities and ability to connect, Van Oort said, and determined a simple pathway for providers to access patient information for most of the Gulf Coast region.

“Needless to say, these capabilities should be in place statewide for incidents like this so that patient record access in emergency conditions is a staple of care,” Van Oort said.

Van Oort said HASA and GHH made sure to brief disaster response officials on the special arrangement, and said he anticipates there will be a greater need to remotely access patient records as patients leave Houston and reach San Antonio or Dallas.

HASA and GHH both have roughly 4 million patients in their systems, Van Oort said.

Physician Experience

For physicians, an EHR system removes the possibility of losing patient data during a natural disaster, Dr. J. Stefan Walker, a partner in Corpus Christi Medical Associates PA, told Bloomberg BNA.

Walker said his clinic is currently closed due to power outages from the hurricane, but when power is restored he anticipates a full recovery of patient data with zero losses.

“Even in the unfortunate case of a total loss of our physical facility, which thankfully didn’t happen, we could plug in to any location with our remote backup and resume normal operations fairly quickly,” Walker, who is also a member of the Texas Medical Association’s Health Information Technology committee, told Bloomberg BNA.

The ability to move locations in case of a total loss of property, without losing any patient data, is a strong argument for utilizing EHRs, Walker said.

Natural Disasters

The benefits of remote access and interoperability, combined with protection from a growing number of natural disasters, makes EHRs and cloud storage a smart idea anywhere in the U.S., Eric Fader, a health-care attorney with Day Pitney in New York, told Bloomberg BNA.

“Health-care provider clients of mine had their paper records destroyed when Hurricane Sandy flooded lower Manhattan, and it was a real wake-up call to other providers in the area, and I’m sure the same thing will happen in Harvey’s aftermath,” Fader said.

Hurricane Harvey is likely to serve as a test of what interoperability can mean for the entire health system, such as home health and rehabilitation facilities, not just communications between hospitals, Alisa Chestler, a health-care attorney with Baker, Donelson, Bearman, Caldwell & Berkowitz in Nashville, Tenn., told Bloomberg BNA.

Emergency preparedness for health-care providers relies on clear and up-to-date information that can be accessed when needed, Chestler said, and Hurricane Harvey will test the Houston health-care systems’ ability to be responsive at all times.

The Department of Health and Human Services issued a reminder to the provider community Aug. 25 about the expectation that patient data be shared as needed, Chestler said, and while the reminder didn’t touch on interoperability, it’s easy to see how this might be included in future emergency reminders to help spur EHR use.

To contact the reporter on this story: James Swann in Washington at jswann1@bna.com

To contact the editor responsible for this story: Kendra Casey Plank at kcasey@bna.com

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