Joplin tornado shows EHR value in disaster

When an EF-5 tornado, among the biggest ever recorded, hit St. John's Regional Medical Center in Joplin, MO, the damage was so severe that all the patients had to be evacuated and taken to other hospitals outside the community. Their medical records were accessible, however, and the hospital was providing care again within a week, all because the hospital had adopted electronic health records (EHRs) only weeks before the disaster.

Five patients died when their ventilators failed after power was lost and the emergency generators were destroyed, says hospital spokeswoman Joanne Cox. There were 183 patients in the hospital at the time of the storm. There were 175 staff in the building, and there were no staff fatalities.

After the tornado passed, patients were helped down darkened stairways to the main level where a triage area was set up outside. From there, patients were transferred to other hospitals.

Communication in the community was almost non-existent immediately following the tornado on May 22, says Mike McCreary, chief of services for Mercy Technology Services, which provides technical support for St. John's and other hospitals in the Sisters of Mercy Health System. The hospital's information technology infrastructure was destroyed along with the building. However, less than one week after Joplin was hit by the deadliest tornado in U.S. history, St. John's again was caring for patients.

New system worked

The process of setting up a 60-bed mobile hospital and tracking patients' medical histories has been significantly aided by the newly implemented electronic health record system and by the quick action of re-establishing communications. In April, the Sisters of Mercy Health System opened a state-of-the-art data center for mission critical applications and clinical data for its 28 acute care hospitals across a four-state region.

The new data center, in Washington, MO, is about 250 miles from Joplin and was unaffected by the violent weather. Additionally, that data was backed up at another distant location. Just three weeks before the tornado hit, St. John's went live on its scheduled switch to its new electronic health records system from Epic Systems Corp. in Verona, WI. St. John's was the last major hospital in Mercy's system to go live with EHRs.

With the patient data from the distant location, hospitals accepting the evacuated patients could access the EHRs quickly using the patients' identification bracelets or other records sent with them. The data also allowed St. John's to resume providing care in their stricken community within a short time.

Patient's records accessed

The hospital provides one example of a patient who benefitted from the use of EHRs: Paul Johnson, 78, of Joplin, had been hospitalized with pneumonia for two days when St. John's was hit by the tornado. His family members were visiting at the time of the tornado. After it passed, they helped guide him down a dark stairwell with the light from a cell phone to the makeshift emergency department outside. He was stabilized before moving to a triage center at McAuley Catholic High School. When patients there were transferred, he expressed his desire to go to St. John's Hospital in Springfield, knowing the Mercy connection and that his records would be easily accessible.

"I knew that they would want to know my medications, dosages, and what tests had been done, and I knew that I couldn't remember all of it," Johnson told Cox afterward. "The doctors in Springfield were able to pull up my records and ask me questions. It worked out beautifully."

Communication restored soon

McCreary noted that St. John's patients also have access to historical medical records. More current health information was stored within the new EHR, and older paper records had been scanned prior to the tornado and are securely stored on servers located in other communities.

Along with the quick access to patient records, Mercy was among the first organizations in the area to re-establish communication services such as phone, network access, laptops, printers, etc., which helped provide the critical link between Mercy's command center in Joplin, the new mobile hospital, physician offices in the community, and other locations across Mercy. (See the story on p. 90 for more on how wireless communications can help after a disaster.)

The local utilities give priority to restoring power and other services at hospitals in a disaster, McCreary says, but it was important for St. John's to have the internal capabilities to act once power was restored.

"If the tornado had hit a month earlier, before installing the electronic health record system in Joplin, St. John's would not have been able to bring up our mobile hospital within a week's time. We still would not be operational at this point," McCreary says. "Today, patients have continuity of care across all of our physician locations and the new St. John's Mercy Hospital, and connection to the entire Mercy health system, because of our EHR and our ability to quickly re-establish communication services."

Source

Mike McCreary, Chief of Services, Mercy Technology Services, Joplin, MO. Phone: (417) 820-2426. E-mail: mike.mccreary@mercy.net.