Back to Basics - A Series Presented by your PAHCOM National Advisory Board
Every medical office should have an actionable disaster plan. This plan should be reviewed by the entire staff at least once a quarter and should include live action exercises so that staff members have a chance to feel comfortable about your practice's plan to succeed during any type of emergency. Your staff should have 24-7 access to your disaster plan and there should be an easily accessible digital copy as well. Some offices have a disaster plan and practice sheltering in place and/or schedule fire drills. That simply is not enough! Disaster plans should contain contingency plans, decision matrices, inventory lists, and appropriate links to local, state, and federal resources.
It is absolutely essential to have a dedicated funding source in the event of a disaster. COVID-19 and the subsequent quarantine have ravaged the American economy. With millions asked to stay home and millions more reducing our workforce to only essential staff, businesses are losing money each day. Medical practices are also facing the same challenges. For some offices, this quarantine meant closing their doors temporarily while still needing to meet payroll and overhead. One best practice is having a line of credit specifically tied to your business during a state of emergency. The key is to prepare to survive for at least three months with no incoming receivables. Although this may be a "worst-case scenario," planning for the worst is the reason for your disaster plan. Knowing that your practice can meet its financial obligations until resuming "business as usual" allows managers to focus on other pressing issues, such as patient care.
A cyber-attack or critical power failure can be devastating to any medical practice, especially to those who use EHR exclusively. Accordingly, we must plan for the potential loss of data and, hopefully, the recovery of critical data. Contingency planning will afford your practice the opportunity to secure your data in the event of an emergency. This type of plan means that you have a blueprint for backing up data and an understanding of what your system is capable of during emergency mode operations. Applications and data criticality analysis are essential to ensuring your practice can continue to thrive despite any ongoing emergency. According to CMS, the purpose of the Application & Data Criticality Analysis is to determine the criticality to your practice of all application-based components and the potential losses which may be incurred if these components were not available for a period of time.
When you can afford staffing and are assured your EHR can store and protect data, be prepared to make some tough decisions about how your practice will move forward during the emergency. Create a decision matrix to determine which positions are essential to your operation. Use the, "Given-When-Then" formula to ascertain how your practice will function during an emergency. For example, GIVEN that most of my patient population are over the age of 50 and have underlying health conditions, they have been quarantined by order of the governor. WHEN they need routine medical care for non-life-threatening illnesses, THEN we will offer tele-health appointments with our providers. Here is another popular example: GIVEN that the number of traditional face to face encounters has sharply decreased; WHEN the number of face to face encounters reaches less than 25%, THEN I will reduce my front desk staffing to one essential staff member who is cross-trained to assist in other areas of the office.
When you refresh your Disaster Plan's Policy and Procedures, remember to write in plain language. Your plan must be easily understood by the entire staff and should include active exercises to reinforce your policy and procedures. Coordinate your disaster plan exercises with your OSHA and safety officers and be sure to make the training fun.
The Federal Emergency Management Agency (FEMA) has tabletop presentations that cover many types of emergency situations such as cyber-attack, earthquake, critical power failure, hurricanes, and chemical accidents. By using available resources, the training can become entertaining and meaningful. Work with your leadership team to define the goals of your disaster training. If you live in an area prone to tornadoes, then use it as one of your focal points. Once your goals are set, create your learning objectives and infuse as many hands-on trainings as possible. When you methodically organize your training modules you build a stronger foundation. Remember to practice often and re-evaluate your Disaster Plan annually. Take into account that healthcare offices are the backbone of this great nation; we ensure continued health and are there to assist in times of need. Let's make sure we stand ready to live up to the promise to our communities.
Thank you to your National Advisory Board for this great information.
Coley Bennett, CMM, CHA
PAHCOM Member Since 2016
Crystal Burning, CMM
PAHCOM Member Since 2010
Kathryn Eiler, CMM, HITCM-PP
PAHCOM Member Since 1995
Kim Krause, CMM
PAHCOM Member Since 2004