HIEs prove critical in disaster scenarios
After a tornado struck Moore, Okla., on May 20 and decimated the Moore Medical Center, the building and old rollers for medical records laid in tatters but “we never lost one ounce of data,” said Brian Yeaman, MD, CMIO, Norman Regional Health System, and medical director of SMRTNET, during a Aug. 13 National eHealth Collaborative webinar.
Oklahoma’s statewide health information exchange (HIE)—SMRTNET—served as a valuable data backup that allowed clinical staff on the frontlines to access crucial baseline information about patients during a distressing time, he said. SMRTNET links data from 2.7 million patients served by 1,400 providers in 68 cities, covering hundreds of millions of data elements. Data from hospitals, physicians, payers and laboratories all feed into it and produce what Yeaman calls a global medical record.
“It’s a real testament to what we’ve done with Meaningful Use, and how we are managing our databases,” he said.
Yeaman said the HIE provided valuable information on the baseline conditions of new patients who came into the hospital setting in the wake of the disaster. For instance, he recalled a young man not responding well enough to morphine and needing a higher-than-usual dosage. However, information in the HIE—which is directly embedded in the EHR—exposed both a past traumatic injury and chronic back injury that had affected the patient's tolerance. “It helped with my comfort level,” he said.
Mark Jones, director, SMRTNET, said that given the Oklahoma City bombing, a major tornado in Moore in 1999, school shootings and Hurricane Katrina, disaster preparedness was “very front and center in the foundation of SMRTNET.”
As a backup to EHRs, Jones said HIEs provide current health data that proves invaluable during disaster scenarios. With the surge of new patients accessing facilities during a disaster with new injuries, quick access to their patient histories helps inform care. Also, “time is of the essence,” and the HIE enabled clinical staff to speed up treatment as they managed to access information that without an HIE would have required a call phone or fax to another provider. Further, he said it helps locate people at their current address and phone number and tracks patient care in the midst of population dislocation.
Looking back at the tornado in Moore, he said the lesson learned was “rapid access means rapid access.” To that end, clinical staff accessed HIE data through the EHR—which proved essential in facilitating their workflow at a time when resources were tight. Overall, SMRTNET usage jumped 15 percent, he said. Meanwhile, fewer providers sought information through portals.
“The big lesson learned is the value of that information to know what these patients look like at baseline. It's extremely important in determining how to manage the patient during the hospital stay,” said Yeaman. “Integration of disparate health systems that tie records together at the point of care as primary use cases is critical.”