October 29, 2012
By Julie Wolter, MA, RHIA, FAHIMA; Marsha Dolan, MBA, RHIA, FAHIMA; and Julie Dooling, RHIT
Hurricane Isaac was just one example of chaos and devastation caused by a natural disaster. In 2011 alone, the Federal Emergency Management Agency reported 99 major disaster declarations, and the National Oceanic and Atmospheric Administration reported 1,096 fatalities from weather events.
Disasters arrive in various forms and often occur without warning. But while we can't predict when they will arrive, we can prepare. Healthcare consumers must actively plan to protect themselves, family members, and loved ones. HIM professionals must plan for anticipated threats and unexpected loss of protected health information (PHI) in their communities.
Disasters Appear in Many Forms Disaster threats can be categorized as acts of nature or human beings. Natural disasters include earthquakes, tornadoes, floods, fires, hurricanes, or an infectious disease outbreak. The latter could be especially important for HIM professionals. Although outside a weather-related scenario, an outbreak of disease could still require hospitals and facilities to implement disaster protocols and even seek external assistance to handle an influx of facility patients and visitors.
Disastrous acts initiated by humans can be broken down into two categories: intentional and unintentional. Intentional disasters include theft, civil unrest, terrorism, and malicious digital action. Unintentional manmade disasters include transportation accidents or chemical contamination.
Regardless of the type of disaster, it is vital that proper measures are taken to preserve and protect the health record.
Personal Patient Records at the Ready Most people evacuate a dangerous environment without a record of their medications and medical treatments.
But patients need to be aware that in the event of a disaster, health records maintained solely by their providers could be compromised. During Hurricane Katrina, more than one million paper-based medical records were destroyed. Medical personnel had to rely on the fallible memory of patients, family members, and friends to recall complex plans for medical care.
The ability to exchange medical information during an emergency is essential to improving the emergency response. HIM professionals must be prepared to assist with the release and transfer of medical records when a disaster strikes. But sometimes the disaster is so widespread that nearby facilities are also affected.
Because of this uncertainty, the consumer needs to be prepared. One way is to adopt an electronic personal health record (PHR) to organize patient health history and document all relevant health information and conditions.
HIM professionals can provide much-needed information to consumers for PHRs before disaster strikes. Consumers need to know how to develop and maintain a PHR and the advantages of patient portals. Both tools help facilitate the gathering of a consumer's medical information and will be invaluable in the case of disaster.
The PHR is an electronic, lifelong resource of health information used by individuals to make health decisions. In a PHR, patients own and manage their health information, either entered through direct input by the patient and their authorized advocates or sent from the healthcare provider's EHR. In times of disaster, the information is more likely to be recovered and retrieved through electronic means than if the information was stored on paper in a single location.
The PHR is maintained in a secure and private environment with the individual determining right of access, and it does not replace the legal health record maintained by providers. But it can be a good backup for patients should the original health record become unavailable or destroyed.
Life and health information management are about planning for the unexpected, and knowing how to recover from those events that just "happen."
HIM professionals need to prepare in order to survive a disaster, and creating a disaster plan for the family home or workplace is critical in helping prevent panic and potential tragedy. Developing a family plan is a good place to start.
To do so, answer these questions.
Do you have a family emergency plan for bad weather, fire, and other emergencies?
Does your family have emergency supplies on hand?
Do you have a designated safe area in your home or neighborhood?
Do you all know what to do in case of an emergency?
Are there special needs in your family?
Patient Portals Offer Remote Emergency Access Patient portals aid consumers in their disaster planning. Portals offer secure, online, and remote access to select health information that is created and maintained in a facility's EHR, then pushed to the portal for access. These systems not only interface with the EHR, but are capable of communicating via the continuity of care record (CCD) standard.
Patient portals serve as a secure communication link between consumers and providers. The expertise of the HIM professional can guide a consumer in the use of the portal and the best route to access their information in case of an emergency.
Patient portals are gaining attention this year since stage 2 of the government's "meaningful use" EHR Incentive Program includes a core objective calling for participating providers to allow patients the ability to view online, download, and transmit their health information.
HIM professionals should encourage consumers to use a patient portal, if offered through their healthcare organization, and provide education on its many benefits.
Providers and HIM professionals also should educate consumers about the advantages of patient portals and emphasize their usefulness in times of disaster. By shifting non-urgent communications from the telephone, ground mail, and in-person methods to the Internet, practices have seen improved efficiencies, reduced operating costs and increased patient satisfaction.
HIM a Natural Patient Advocate HIM professionals need to be prepared to work with consumers in their development of a PHR or patient portal. Some ways to help include:
Advocate the use of EHRs for all patients
Educate consumers about the importance of creating and maintaining a PHR
Work with component state associations, and regional and local associations to provide education to consumers about the ways portals and PHRs help in times of disaster
HIM professionals have been at the forefront of the PHR movement for years. HIM professionals have also moved into roles developing and maintaining patient portals. They are advocates for consumer privacy, particularly in the management and use of consumer information, and are advocates for the patient's right to access their own records.
HIM professionals have the knowledge and experience necessary to educate the public about the correct methods for maintaining health records and should help consumers get the needed data to start and maintain PHRs or access a portal.
When managing a PHR or patient portal, HIM professionals should:
Ensure healthcare facilities do not create barriers for patients who want to obtain their own health information
Plan how PHR/patient portal information will be incorporated, stored, and maintained within the facility's EHR
Advocate for HIM professionals to fill job roles that oversee patient portal interaction and patient access issues
Be able to explain how the information can be used by individuals and their physicians, and how the information can be used by others (i.e., encourage patients to review the notice of privacy practices document)
Understand the role, function, and information requirements for the PHR and patient portal; understand how secure portal access is achieved, as well as maintenance and workflow practices
Learn and educate others in the healthcare community about the usage of PHRs and patient portals in relationship to health information exchanges, accountable care organizations, and the Nationwide Health Information Network
Prepare for Disasters Now HIM professionals have the skills to help their facility or providers in a time of difficulty or disaster. These skills allow them to organize and manage information and data, and help plan for ways in which patients will be cared for. The same skills that an organization will depend on when faced with a disaster also will help a family prepare for a disaster.
HIM professionals understand the need for preparation and have usually undergone special disaster preparedness training.
Medical information is typically important to have when a disaster hits, and HIM professionals can provide patients with guidance, education, and support in the use of personal health records and patient portals, bringing this vital information as close as a mere click away.