EHRs Play a Role in Disaster RecoveryFor Hospital Hit By Tornado, EHRs Proved Vital
Ironically, the hospital had upgraded its electronic health records system, using an application from Epic Systems Corp., just three weeks before the storm. Plus, the new EHR system was housed in a new shared data center offsite, rather than the local data center, which was destroyed in the storm.
The EHR system proved to be "absolutely critical" in the wake of the tornado, says William Showalter, CIO for Sisters of Mercy Health System, which owns St. John's. "It provided the capability to deliver coordination and continuity of care. ... The EHR allowed clinicians to manage ongoing care for patients ... when department-based [paper] records would have been wiped out."
Within hours of the tornado, the hospital set up an emergency operations center at the nearby Holiday Inn Convention Center to provide services to the community. Working with staff from the hospital and its parent organization, the Missouri Disaster Medical Assistance Team, assisted by the National Guard, set up one of its mobile medical units within less than a week. The unit was equipped with supplies, beds and technology, with equipment borrowed from other Mercy sites.
The mobile medical unit, which began accepting patients May 29, included a 20-bed emergency department, two surgical suites, imaging capabilities, pharmacy and lab services, two helipads and 40 acute care beds.
Restoring CommunicationThe emergency operations center as well as the mobile medical unit relied on microwave satellite transmissions to and from Mercy's new corporate data center, located 45 minutes outside of St. Louis. (Mercy also has a second corporate data center for backup). A wireless bridge linked the mobile unit to a Mercy facility to enhance and expand bandwidth.
"Wireless voice and data was the focus of delivery to minimize the wiring requirements," Showalter says. "To accelerate the voice communications, VoIP [Voice Over Internet Protocol] wireless was utilized."
Once the mobile medical unit was operational, Showalter and his team created a disaster recovery plan for the temporary facility. "We wanted to ensure that the fragile environment could be managed in the event of a disaster," he says.
Most of Mercy Health System's hospitals, including St. John's, have had some components of EHRs in place for about 10 years. In 2007, Mercy began shifting to a standard approach, relying on the Epic Systems application, Showalter explains. St. John's went live with Epic at the beginning of May, just three weeks before disaster struck.
The standard, system-wide approach to EHRs, paired with the corporate data centers, proved to be critical in the wake of the disaster, Showalter says. "Having consistency allowed us to go in really quickly and bring the system up. We were able to leverage resources across the health system because the technology was the same."
EHRs and Business ContinuityIn a recent blog, Farzad Mostashari, who heads the Office of the National Coordinator for Health IT, called attention to how St. John's experience illustrates the value of EHRs.
"The aftermath of the storm highlighted a major difference between paper records and EHRs," Mostashari wrote. "The paper records still in the hospital on May 22 were literally blown to the winds. Some records had been found as far as 75 miles away in Springfield. ..."
Mostashari noted that Dottie Bringle, R.N., chief operating officer at St. John's, believes that the EHR system was crucial in tracking patients and providing medical information readily after the storm. "Having an EHR allowed us to be able to know exactly who all the patients were in our hospital so we were able to locate each and everyone fairly quickly after the EF5 tornado hit," she said. "If we only had paper [records], it would have been very difficult to manage our patients."