When thousands of Gulf Coast residents fled Hurricane Katrina, many of their paper-based medical records were soaked or blown to the winds. Ever since, proponents of electronic health-record systems
and health information exchanges
have promoted those technologies to keep health information secure and accessible when disasters strike.
In and around Oklahoma City last week, that promise was largely fulfilled.
The tornado that struck Moore, Okla., on May 20 knocked out Internet communications to Moore Medical Center, the city's lone hospital, a satellite of Norman (Okla.) Regional Health System.
About 30 patients were evacuated from Moore Medical in the south suburb of Oklahoma City to the system's unscathed flagship, Norman Regional Hospital, and its HealthPlex surgical hospital, also in Norman, both less than 10 miles farther south.
Since the main campus hosts the Meditech EHR systems for all three hospitals, even with Internet connectivity knocked out, Norman “didn't skip a beat,” said Dr. Brian Yeaman, a family physician and practicing hospitalist and the system's chief medical informatics officer. “And we didn't have the risk of those paper records flying for miles.”
Yeaman also is the medical director for the Greater Oklahoma City Hospital Council and coordinator of its health information collaborative, a subset of Oklahoma's
broader Secure Medical Records Transfer Network, or SMRTnet, a 7-year-old regional health information exchange organization that also was tested by the storm.
Copies of patient records for more than 2 million people are stored by SMRTnet at a Cerner Corp. data warehouse “buried in the side of a large, manufactured hill in Kansas City,” said Joanna Walkingstick, director of member services at SMRTnet. Those records include patient demographics, visits, procedures, lab results, vital signs, histories and physicals, discharge summaries, discharge medications and radiology reports.
“This is the first time we've been tested like this,” Walkingstick said. Network traffic spiked after the tornado hit, and the system “scaled” and “handled the traffic load, very, very well,” she said.
There was a weak link: The lines of the fiber optic cable provider used by Norman Regional Health to connect to SMRTnet were cut just after 3 p.m., when the tornado moved eastward across Interstate 35, the main traffic artery between Oklahoma City and Norman.
The ensuing destruction disconnected Norman from the RHIO until about 10 p.m., when service was restored.
Links between SMRTnet and other network member hospitals stayed open, however, Yeaman said, including to the Integris Southwest Medical Center, 10 miles north of the now-iconic Plaza Towers Elementary School destroyed by the tornado.
“Everybody had access to the data they needed,” said John Delano, vice president and chief information officer of Integris Health, which has five hospitals in the Oklahoma City area.
“We did not lose connectivity,” Delano said. “Our (Cerner) electronic medical record is remote hosted in Kansas City. We've got two ways to get to that: We've got a private connection and we have the ability to access them via the Internet should we lose that. And, we keep a local copy of the data. And we're connected to SMRTnet. We also use Allscripts in our ambulatory environment, and we're in the process of dumping that ambulatory data into that HIE as well.”
Integris providers treated 92 tornado victims, 20 of whom were admitted, 10 in critical condition, and one of whom died, said Brooke Cayot, media liaison for the system.
Yeaman said SMRTnet connects 90% of the hospital beds in the greater Oklahoma City area. Research by the local hospital council, he said, indicates that 68% of the area's patients “touch more than one health system and 25% see three or more.” That diffusion of patients was most certainly the case after the storm.
Injured Moore residents, who ordinarily would have sought treatment in their city's hospital, did so across the metro area.
“We were able to put that information in those providers' hands (Monday night) to make very difficult decisions on some very sick patients and drive care,” Yeaman said. “It's absolutely mind-boggling to think about the corner we've turned.” Follow Joseph Conn on Twitter: @MHJConn