Plan for the Worst Before
Disaster Strikes

Preparation, foresight is key when the unexpected happens.  

by Antoinette Vecchio
Associate Editor

A power outage at a hospital threatens not only the information systems, but the lives of patients—especially those on respirators. A plane crash injures hundreds from different parts of the country and the world, and emergency crews must access information from patients who cannot speak or don’t speak the same language. A medical facility is damaged, destroyed or must be evacuated, and patient records need to get to another location.

These are just a few scenarios the healthcare industry faces when disaster strikes. But how well are hospitals prepared for these situations? A recent survey by HospITech Solutions reveals all hospitals have a natural disaster emergency plan, but only 55 percent of responding hospitals subscribe to an information technology disaster recovery plan.

“We believe that even though the patients’ well being is most important during a disaster, hospitals also need to consider protecting the technology supporting patient care,” says Don Seiden, president of HospITech Solutions.

Since the survey, the results of which were released in April, Seiden says he has seen an increase in interest in IT disaster planning. Three things are sparking that interest, he says: the freeing of funding after the Y2K scare; more affordable client servers; and the need to comply with the Health Insurance Portability and Accountability Act (HIPAA).

There are a number of ways hospitals can plan for disasters, whether they are natural, technological or accidental.

Planning Is Essential

Having a plan in place before disaster strikes is imperative. According to Dee V. Halbrook, technical consultant for IRM International, the disaster plan should be done in four phases: Planning, implementation, test and refinement. 

At a poster session at the 1999 HIMSS Conference and Exhibition, Halbrook offered these suggestions on forming a disaster plan:

The planning phase should include meetings with steering and work teams, a tour of the facility, collection of current documentations and question-and-answer sessions.

The disaster plan notebook should be kept at the hospital, at employees’ homes and at an off-site data storage facility. The notebook should include sections on employee call trees, network configuration, communications closets layouts, cable diagrams, port connections, server configuration, backup schedule and disaster scenarios.

Testing the plan before a disaster will allow everyone in the organization to learn what to do when the disaster occurs, and will also reveal any shortcomings in technology for the hospital data network and the plan, allowing time for refinement. The better prepared the organization is, the faster the recovery will be.

Uninterrupted Power Supplies

One of the most important factors in preventing IT disasters is a constant energy flow. Power outages not only cause life-saving equipment such as respirators to shut off; they also cause computers to shut down, making vital patient information unattainable. 

An uninterruptible power system (UPS) can save the lives of patients and make delivery of care constant. Generators often don’t take over for as many as 15 seconds, which is a long time for critically ill patients and for IT personnel. 

A UPS uses a charger or rectifier, battery plant, inverter or converter, and static switch. Run times of UPSs vary depending on the size of the battery and the amount of electrical load connected to the UPS. Sealed UPS batteries typically last five years and need to be recycled. 

Accessing Patient Information

When natural disasters such as tornados, hurricanes and earthquakes occur, or when accidents occur, such as airplane crashes or train derailments, patient information may need to be obtained at the scene.

To get the critical information they need, rescue personnel rely on communication equipment that can quickly, accurately and securely relay medical information. This is done mainly via radio with paramedics in the field talking to doctors about the needs of patients. While this technology and the extensive training of paramedics is a far cry from the days when doctors carried medical records to the field, a new way of obtaining patient information is on the horizon. 

Technology can now embed a person’s medical records and medical history on a swipeable wallet-sized card, says Don Hermey, chief safety officer at Sarasota Memorial Hospital in Sarasota, FL. 

The cards will be especially useful to those who travel, Hermey says. In situations where rescue personnel cannot identify a patient, medical records cards can provide that information. They can also offer pertinent information that can’t be obtained from a patient who is unable to speak or who speaks a different language.

While the technology isn’t commonplace, it is on its way, Hermey says.

Relocating at a Moment’s Notice

Explosion, earthquake, fire, tornado, hurricane—these are all phenomena that can damage or destroy a hospital. Getting patients and medical professionals out of the hospital and into another building is one problem; getting medical records and medical equipment transferred is another. 

If a hospital has a computerized charting system, the information can be downloaded onto a disk, while hard copies of charts must be gathered and carried out. This was the case at a medical group office in Circleville, OH.

At 5 p.m. Oct. 13, 1999, a tornado swept through town, ripping off the roof of the Pickway Medical Group Office. Rain flooded the office, and the paper medical files were damaged.

“We worked day and night in the rain” pulling the files from the building, says Brenda Short, assistant to the executive director. Hundreds of records were unusable. Many were water damaged or misplaced. A number of records were placed in a meat freezer or laid out in a locked room to dry. It took 30 days to account for all the files, Short says. 

Avoiding this type of disaster is as easy as scanning a file. Document imaging and electronic medical records not only provide fast and secure access to patient information; they also make relocation of such files as easy as loading the information onto a disk. 

Another benefit to electronic records is the ability to easily store the information at an off-site facility. Or, hospital officials may outsource their record-keeping or put their files on the Internet for immediate access.

Remember, with any disaster plan, preparation is the key. The more prepared a hospital is, the faster it is likely to recover. 

Is your facility prepared for disaster? Take the IRM International “Healthcheck” and find out. www.irminternational.com

Y2K Efforts Yield Long-term Benefit

By Jeff Album is director of public information at Delta Dental Plan of California.

Thirty million dollars seems like a lot to spend fixing the Y2K bug, but company officials at California’s largest dental health plan and its HMO affiliate company say Y2K contingency planning yielded another benefit as well: disaster preparedness.

At 12:01 a.m. Jan. 1, a fully staffed command center helped Delta Dental Plan of California usher in the New Year with continuity of service to 12 million enrollees, 18,000 dentists and 14,000 corporate and government client groups. PMI Dental Plan, Delta’s dental HMO affiliate, with another 1 million enrollees, maintained a vigil at its Cerritos headquarters. 

Delta and PMI did more than reprogram millions of lines of computer code to keep its claims processing, customer service, eligibility and billing system working. The company installed a crisis management and communications system capable of supporting a full or partial business recovery if the worst-case scenario had unfolded. 

“Our Y2K contingency plan worked flawlessly and now leaves us better prepared to face earthquake, flood, fire and many other possible catastrophic events with the potential to disrupt service,” said William T. Ward, Delta’s president and chief executive officer. 

The companies updated employee phone trees, established crisis command centers and insured regular updates to key personnel regarding the Y2K readiness of their facilities, data systems, applications and security.

Delta employees now know exactly who is responsible in any emergency to assess what is working and what isn’t, and to able to contact staff members who would be most critical in bringing systems back on line. 

“I’m not saying I’m glad we had to spend $30 million on Y2K,” Ward says, “but since the investment was necessary, it’s good to know that the same planning necessitated by the millennium bug prepares us to undertake almost any kind of recovery effort.”

June 2000