Weathering the storm: CT, EHR prove mission critical
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| Back side of medical building in Joplin, Mo. after EF-5 tornado on May 22. |
“We had a textbook of major trauma on April 27,” recalled Daniel W. Young, MD, clinical professor of radiology and pediatrics at University of Alabama Birmingham School of Medicine and a pediatric radiologist at Children’s Hospital of Alabama. Patients presented with burst fractures of the lumbar spine, intracranial hemorrhages and other severe injuries. “Making the diagnosis as quickly as possible was the name of the game,” Young said in an interview with Health Imaging News.
In the early evening, after the major tornadoes struck Tuscaloosa and the suburbs west of Birmingham, patients flooded into the hospital, which had 54 seriously traumatized patients arrive in the emergency room in the hours immediately following the storm.
Triage started in the parking lot, with physicians ordering CT studies with minimal patient history other than “disaster patient.”
The radiology department completed 151 head, neck, chest, abdomen and pelvis CT studies on 37 patients and 176 plain films through the night, surpassing its previous one-night record of 30 CT studies by a factor of five.
“We had a patient on and off the scanner every 12 minutes all night long and reports were out within 15 minutes,” said Young, who credits the department’s 64-slice helical scanner, RIS/PACS and voice recognition technology with his ability to manage the onslaught as the sole radiologist through the night.
Young shared several lessons learned from the storm, including:
- Maintain general diagnostic skills in reviewing studies of the head, neck, chest, abdomen and pelvis.
- Invest in a modern CT system (i.e. 64- or higher-slice with reformat capability) and voice recognition software.
EHR proves vital to mobile hospital
When the EF-5 tornado hit Joplin, Mo., on May 22, it destroyed St. John’s Regional Medical Center, part of Sisters of Mercy Health System (Mercy). Yet St. John’s was open for business within one week at a 60-bed mobile hospital, partially due to newly implemented EHR technology.
In fact, the technology proved its merit within minutes of the storm, said Mike McCreary of Mercy Technology Services. With most of the community’s communication systems down, Mercy established a centralized regional command center in Springfield, Mo., where staff started pulling and printing patient records for the 183 patients hospitalized at St. John’s in Joplin who required transport to other sites.
“We didn’t know where patients were going and what capabilities would be onsite. We dispatched people with paper records to take them where needed,” explained McCreary. The rapid response and universal availability of patient data ensured continuity of care.
For example, one of the 183 patients who was hospitalized with pneumonia and scheduled for a biopsy before the storm requested transfer to a sister hospital, St. John’s in Springfield, where staff accessed his records and re-ordered the biopsy, keeping the patient on track despite the total devastation of the hospital.
The timing of the storm was eerily fortuitous, as the medical center went live with its EHR on May 1 and had commissioned a state-of-the-art data center for business continuity on April 1.
In addition, recent staff training in EHR technology streamlined the transition to the mobile hospital. McCreary said the health network’s standards for applications and equipment helped ensure smooth processes at the mobile site, which was linked to the network via a satellite.
Mercy’s investment in technology also enabled physicians who practiced at specialty and general practices clinics that were destroyed to continue to provide care at temporary sites as patient history remained readily available via the EHR.
Two months after the storms, Young concluded, “Technology made a huge difference. We could not have done this 10 years ago.”