In the wake of Hurricane Sandy: Health IT 1, Paper Records 0

“When the levee breaks I’ll have no place to stay.” Led Zeppelin

Many people in New York and New Jersey have much to be thankful for this Thanksgiving. Maybe you saw the report about 62-year-old Staten Island grandmother Phyllis Puglia, whose home was leveled by Hurricane Sandy but was able to begin to rebuild her life after the disaster.

NBC News showed the scene of Puglia Exit Disclaimer digging through the rubble of her home. Wearing a borrowed FDNY sweatshirt and weeping, Puglia unearthed cherished family photos and some other documents from the debris. In the wake of Hurricane Sandy, people on the East Coast, especially those in New York and New Jersey, will be busy this Thanksgiving rebuilding their lives, so our thoughts are with them.

Puglia’s family photos got us thinking at ONC:

Were patient records lost or destroyed during the storm? Are these documents floating around Southern Manhattan or along the Jersey Shore somewhere? How did health information technology systems fare? The answer is, unfortunately, paper patient records were another casualty of the storm. Health information technology, meanwhile, held up well.

Administrators at a recently-acquired Federally Qualified Health Center (FQHC) in Queens had begun the lengthy process of transferring from paper records to an electronic health record (EHR) system when Hurricane Sandy interrupted the upload.  According to officials at the Community Health Care Association of New York State (CHCANYS), the Queens FQHC lost 1,500 paper records as the water levels rose.

Lawrence Armenti, a Newark primary care doctor, said the process for rebuilding a lost or destroyed paper record is difficult and time consuming. Doctors are legally required to keep patient records for seven years, so it has to be done. To start, Dr. Armenti suggested notifying the insurance companies involved so they can record that the file is lost. Physicians can try and rebuild the record using data from labs, hospitals or other providers. Information from the past 6 to 18 months should be included, he said.

The health IT system, however, was not affected because the data was being stored offsite, the official said.

About three weeks after the storm, CHCANYS officials said they remain unaware of any lost patient data from their participating clinics that use health information technology. (By the way, clinics in New York have one of the highest adoption rates of health information technology in the country, near 90 percent, according to CHCANYS.)

“As Sandy devastated areas of Staten Island and other boroughs of New York City, it wasn’t able to corrupt electronic data,” said Lee Stevens of the State Health Information Exchange Policy at ONC. “I don’t believe there was even one server lost,” Stevens said, referring to data storage of EHRs in New York/New Jersey.

“They’re still assessing what happened, but we know that it stayed up everywhere, with the potential exception of NYU Langone, where we expect to learn more. Things were not dire by any circumstance, except for those who had to be moved. But patient records were available electronically,” he said. The problem was the power, not the health information technology.

While Langone’s generators are on higher ground, fuel tanks to run the generators were in the basement, according to published reports.  The storm surge, initially predicted to be about 12 feet, topped out at 14 in southern Manhattan.

Rebuilding Patient Records after Hurricane Sandy

Some health care providers had to learn the hard way about the value of having patient information stored electronically in an EHR vs. a paper record.

Dr. Lawrence Armenti, a Newark primary care doctor, said the process for rebuilding a lost or destroyed paper record is difficult and time consuming. Since physicians are legally required to keep patient records for seven years, it has to be done.

To start, Dr. Armenti suggested notifying the insurance companies involved so they can record that the file is lost. Physicians can then try and rebuild the paper medical record using data from labs, hospitals, and/or other providers for the past 6 to 18 months.

So what are the takeaways from the storm as far as health information technology is concerned?

Lessons Learned from Hurricane Sandy

Thomas Ortiz, a family physician and medical director for the NJ-HITEC program in Newark, lost power for eight days. With 38 EMR stations down, Dr. Ortiz and his team were able to see patients during daylight hours, but unable to access their data.

Dr. Ortiz learned a couple things from the storm and has suggested a few precautions to help keep records secure in the event of a natural– or unnatural–disaster:

  • Store data at a remote location
  • Shut down your health IT system if you know a disaster is imminent
  • Back up data continuously
  • Buy a generator so you can, at the very least, receive telephone calls
  • Draft a manual paper plan that includes policies and procedures to capture patient data while the power is out; once power is restored, scan the data into the EHR

Dr. Firpo Guerrero, a physician in Newark, NJ, who works with the NJ-HITEC, was recently interviewed for the Health IT Buzz Blog about his experience with EHRs, and how he prepared his office for Hurricane Sandy. He shared the following advice for health care providers preparing for a storm or other type of disaster: “Back up your files, invest in a generator, and select an IT company that is customer service-focused to answer all your questions and walk you through any problems.”

Health information technology is critical for disaster preparedness and response, and it did apparently help doctors and hospitals keep patient information secure, but unprecedented disasters teach us new lessons each time.

“All this information was available all the time,” Stevens said, but even so “an electronic health record is not going to fight back flood waters.” The systems did, however, stay up during the whole event for millions of people,” he added.

Note: Stay tuned for more tips and lessons learned at HealthIT.gov. Also, be sure to subscribe to our Health IT Buzz blog.

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