HIE during a natural disaster

Sept. 21, 2018

In a state of imminent natural disaster where patients must be evacuated quickly, a health information exchange (HIE) seems the obvious choice for sharing health information between evacuating and receiving facilities. Most hospitals have agreements between neighboring local, state, and regional facilities where patients may be evacuated in emergency situations.

However, not all facilities necessarily belong to the same HIE, regardless of their proximity, where a shared patient database can provide online retrieval of patient health information. If the receiving facility does not participate in the same HIE as the evacuating hospital, those records are as good as non-existent. Imagine finding a transfer facility where you can send patients in a matter of hours before roads become hazardous … only to learn you will need to print hundreds of pages of electronic records because they are not part of your HIE.

One health system in Augusta, GA experienced such a conundrum during Hurricane Matthew in 2016. By the following year, when Hurricane Irma threatened Florida and Georgia, Augusta University Health took those lessons learned the prior year to prepare themselves to send and receive patient information. They established connections to other large medical centers through the Georgia Regional Academic Community Health Information Exchange (GRAChIE) and with Cerner clients in large medical centers within the state.

During the Hurricane Irma emergency, they received displaced patients from neighboring states. In anticipation of those evacuees, they worked with GRAChIE leadership to identify participants in the eHealth Exchange, formerly known as the Nationwide Health Information Network (NHIN), from the predicted evacuation areas. GRAChIE worked to contact those participants to create and test connections to their HIE in advance of moving patients.

These connections provided a more seamless transfer of patients and saved both facilities time and resources that would otherwise have been allocated to the age-old task of copying and packing records for transfer.

As hospital emergency management leaders work to prepare their facilities for natural disasters, they must not only consider their own connectivity to an HIE. They must take into consideration smaller facilities that send or receive patients and may not be connected to an HIE. Consider making a list of area facilities, large and small, and gain information from their leadership on how they could potentially connect to a shared electronic resource in an emergency.

Also, they must take steps to contact their own HIE vendor to understand their capabilities for temporary emergent connectivity and service. There are many benefits in participating in an HIE, but what are their capabilities during time-sensitive emergencies? Will they be able assist you during a natural disaster to create and sustain the flow of patient information?

Journal of AHIMA has the story