May 22 marks the one-year anniversary of the tornado that ravaged Joplin, Mo. Last year was the United States’ fourth deadliest year for tornadoes on record, according to Accuweather.com. And 2012 is likely to be an active for twisters as well. Mighty storms have already hit Alabama, Dallas and Harrisburg, Ill.
Natural disasters, like tornadoes, floods, hurricanes and wild fires, are unavoidable. They are going to strike no matter what. However, we can prepare for them. Notwithstanding the severity of a disaster, the extent to which a community, hospital or health system is prepared will greatly influence the management of medical emergencies and patient care.
Back in 2005, when Hurricane Katrina hit the Gulf Coast, nurse practitioner Scharmaine Lawson had the foresight to backup basic patient information on her Palm Pilot. According to an ABC news story, while Lawson’s office was 5 feet under water, she could still to share her patients’ health information with the providers across the country caring for the displaced New Orleans residents. However, at that time, Lawson was a rarity and many patients lost their healthcare records that were kept in paper charts.
When the tornado tore through Joplin last y year, St. John’s Regional Medical Center sat directly in the funnel cloud’s path. The hospital was destroyed. It was reported that paper charts and x-rays were found as a far as 75 miles away.
But patient care did not cease. Just three weeks before the tornado, St. John’s had implemented electronic health records, according to the U.S. Department of Health and Human Services. As part of the Sisters of Mercy Health System, St. John’s was able to transfer patients to other facilities in the system and know the patients’ health records would be intact and accessible. A week after the tornado, St. John’s had set up a tent hospital where healthcare providers could access EHRs.
While use of EHRs by office-based-physicians has increased to an estimated 57% in 2011, up from 18% in 2001, we still are not using EHRs to their full potential. The patients at St. John’s could be transferred to other facilities because they were part of a health care system with an integrated EHR system.
What happens if a patient is visiting a family member in another state and has a car accident or some other type of health emergency? If it were me, my healthcare records would still be here in Illinois since the healthcare system I use does not have facilities in other states.
To really get the benefit of EHRs, we need to have a nationally integrated system. The U.S. military has a system called Armed Forces Health Longitudinal Technology Application (AHLTA). Service members’ EHRs are integrated across bases and military branches. They are also available internationally, so if a service member is stationed in Afghanistan, their EHRs are still accessible. Perhaps most interesting is the mobility of these records. According to the blog Baseguide, military medics in deployed areas can access service members’ medical records via handheld device. Any intervention the first responders provide is available to military healthcare providers both abroad and at home.
Many innovations in health care have come out of the military. WWI gave us advances in plastic surgery. The Vietnam War gave us advances in trauma care. The wars in Iraq and Afghanistan will likely contribute new developments in prosthetics and treatment of traumatic brain injuries.
The Madigan Army Medical Center in Tacoma, Wash., is working on EHR pilot project with Riverside Health System to see how to integrate personal health records in a civilian environment.
Tragedies like war and natural disasters can be devastating but they can also lead to new ideas, new systems and new technology. Hopefully, they will lead to use EHRs to improve patient care during medical emergencies.
And speaking of new developments, on April 9 Mercy Hospital in Joplin opened, just across the street from where St. John’s once stood.
Jennifer Thew, RN, MSJ
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