Guest Columns

A lesson in disaster preparedness for LTC facilities

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LeRoy Boan
LeRoy Boan

As healthcare entities throughout Texas and Florida work tirelessly to put back the pieces following hurricanes Harvey and Irma, reflection is likely top of mind. These devastating storms and resulting widespread power outages are a true test of just how far healthcare technology has come. They are also a strong reminder of the importance of disaster preparedness to ensure continuity of care.

Natural disasters happen. Hurricanes, snow storms, earth quakes; no business or person is immune. Independent of natural disasters, widespread power outages can occur any time. For those who don't account for the possibility, the impact can be substantial. Continuity of care and patient satisfaction will be negatively impacted, and a facility's reputation potentially damaged.

To ensure continuity of care, everyone involved in patient care must be aware of each resident's complete medical history at all times. This information is essential to avoid duplication of medications and miscommunication on the resident's plan of care. With patient health information in hand, existing medical conditions and current treatments can be viewed regardless of where a patient is physically located or what natural disasters may occur.

Technology such as electronic medical record systems  and clinical software systems are increasingly utilized in long-term care facilities to help streamline day-to-day processes and workflow. These same systems can (and should) be used to ensure continuity of care during an emergency.

While most long-term care facilities have disaster preparedness plans in place, many of these plans don't incorporate the use of technology. Equally as alarming, those plans that do take technology into consideration are rarely (if ever) tested by facility staff prior to an actual event. It is only when a disaster happens that many discover the plan they have is inadequate, no one knows how to use it, and/or it simply doesn't work. When this happens PHI is inaccessible and staff are left scrambling. If a mock drill is not conducted in advance of an event, there is no way to know if the processes outlined within your plan will work.   

Disaster preparedness is much more than some steps printed on paper and stuck in a folder, binder or policy book. It is developing a plan and testing that plan, step by step, to make sure it works and that everyone is familiar with their role. It also requires getting your EMR vendor involved.

Power outages and lost internet connection should not render PHI inaccessible. There are various ways to access information regardless of the situation. It's important to work with your EMR vendor, before a disaster strikes, to determine which approach is right for your facility and your budget.  

Many long-term care facilities have a generator back-up (red outlet). These generators can be wired to power your server and your printer. For example, using transactional log shipping your EMR vendor can set up a minimal SQL database on a computer that is connected to outlets at your facility that run off of a backup generator. This allows information to be accessed directly from your laptop. Staff accessing information on the laptop can either share or hook the laptop up to the printer to print information.

If an Internet connection is required, your vendor can work with you to set up a dedicated laptop with its own ISP Verizon, Sprint or other provider's data card that connects to 4G Internet.  You simply register with a hosted service/EMR provider and set the laptop aside in a safe place in the event of a disaster.  In either scenario, if a long-term outage and/or resident transfers are necessary, PHI can be saved from your laptop to an electronic file for easy handover.

In an event of a disaster, when there is no internet and no electricity, it is essential that long-term care facilities have a tested plan in place that allows PHI to be accessed and shared. 

How do you do this? Talk to your EMR vendor — they have solutions. Your EMR vendor should play a key role in deciphering the needs of your facility and work closely with you to design (and test) a disaster recovery plan that actually works. Maintaining continuity of care during a disaster doesn't have to cost a fortune. It doesn't require special interfaces nor a lot of ground work.  However, it does require a partnership with your EMR vendor.

LeRoy Boan, ASN, CPHIT, MSIT, is a nursing and health IT expert at Cantata Health.
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