OBSERVATIONS - January 11, 2008
Lessons From Southern California Wildfires: Clinical IT Fosters Continuity of Care
The devastation of the Southern California wildfires of 2007 will not be forgotten soon. Nine people died as a direct result of the fire; nearly 100 others were injured, over 2,000 homes were destroyed, and over 500,000 acres of land burned from Santa Barbara County to the U.S.–Mexico border. But there are other stories from the wildfires—lesser known positive stories—with lessons learned that are relevant to policy and health care leaders.
One of the positive experiences from the 2007 fires was the benefit realized from the use of clinical information technology in responding to health care issues during the crisis situation, especially within the San Diego area. Skip Skivington, leader of Kaiser Permanente’s healthcare continuity management oversight group, recently reported the following lessons learned from the Southern California disaster:
Clinical IT System Helps Mitigate Patient Inconvenience:
“During the crisis, KP’s San Diego medical offices were opened and closed each day based on the fire line, wind orientation, etc. These changes, often on short notice, meant members were frequently directed to a medical facility they hadn't visited before, and saw providers they hadn't seen before. The outpatient component of KP’s clinical information system, HealthConnect, had been installed a few months prior to the fires, and having HealthConnect in the exam rooms significantly enhanced the care experience during the disaster by allowing the ‘new’ providers access to the member's history, current medications, and lab results.”
Clinical IT System Supports Continuity of Provider Coverage:
“Physicians whose normal work locations were closed due to the fires were in some cases redirected to another Kaiser Permanente medical facility, and in some cases were required to work from home. HeathConnect facilitated business continuity through inter-facility and remote access capabilities. And virtually no limitations were reported except for printing at home. During the crisis HealthConnect provided the following benefits:
- Physicians were able to log into the HealthConnect system and respond to clinical business, refill Rx's, review lab results, answer patient questions, schedule future appointments, and direct members to open medical facilities, etc.
- In some cases, providers called patients at home, then based on the discussion over the phone, directed them to an open medical facility (same day) to see an alternate provider, or were able to electronically prescribe for their patients to pick-up at a pharmacy.
- Covering physicians were able to check their colleagues’ HealthConnect “InBaskets” to ensure continuous, seamless care when patient handoff from one physician to another was necessary during the disaster.
- Providers were also able to check the HealthConnect InBaskets for their triage RNs who were not on duty due to the fires, in order to provide the required level of care.”
Like Hurricane Katrina, the Southern California wildfires of 2007 sharply underscore the tangible benefits of clinical information technology in disaster recovery and health care continuity during a major crisis. “Secure remote access to patient records and HealthConnect applications went smoother than expected, was easier than anticipated, and allowed effective continuity of care despite the widespread and rapidly changing fires across much of the service area,” Skivington said. “This enhanced capability, brought on by HealthConnect, will fundamentally alter our disaster planning response scenarios, and enable Kaiser Permanente to respond much more efficiently and effectively to all types of disasters, to include a bioterrorism or widespread infectious disease event.”
-- Brian Raymond, MPH, Senior Policy Consultant,
KP IHP
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