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Health, Science, Environment

Electronic medical records prove to be critical in Joplin disaster

This article first appeared in the St. Louis Beacon, June 9, 2011 - Days after a tornado leveled parts of Joplin and heavily damaged St. John's Regional Medical Center last month, a version of MASH without the humor rose on a parking lot near the 370-bed hospital.

Made of blue, orange and white tarpaulins, the 60-bed mobile hospital is a lot more sophisticated than it looks. Underneath its tents is enough high-tech gear for imaging tests, surgery and other services to help care for the wounded following one of the nation's deadliest tornadoes. The twister caused at least 142 deaths, including five of the hospital's patients.

One of the lucky patients was Paul Johnson, 78. He still talks about how the storm forced him to confront life and death -- and how it suddenly made his pneumonia seem secondary.

He praises health workers for getting him "bandaged up enough" to be transferred to St. John's Hospital in Springfield, where he was a patient for five more days. Johnson says everything doctors in Springfield needed to know about him "down to my antibiotics" was readily available, thanks to Mercy's electronic record system.

Backup System Is Key To Recovery

Officials at Sisters of Mercy Health System, which owns St. John's, say one key to getting the hospital back on line was a decision made more than five years ago to build an electronic health records system for all of its hospitals. Such systems will be a federal requirement for all hospitals by 2015.

Even an electronic system doesn't protect all records since a hospital is constantly scanning and converting to digital files a lot of patient data that might be faxed from sources outside a hospital. The tornado blew some of those paper records miles from the hospital, says Mike McCreary, chief of Mercy Technology Services. But he says the larger point is the importance of shifting to an electronic records, a move that St. John's had made only weeks before the tornado struck.

Mercy protects those records through a backup system at a data center in Washington, Mo. It is the repository for electronic records from all hospitals in the Mercy system. "Having all our records housed in a different location allowed us to be up and operational as a health-care facility within a week," he said. Without that backup, McCreary says St. John's "still would not be operational at this point."

One lesson, McCreary and others say, is that technology does have shortcomings in the midst of a disaster. Health-care providers and others in Joplin quickly learned that smart phones and some other high-tech services turned out to be useless for those in the heart of the disaster zone. Others say that weather radios may turn out to be the best window to the outside world when a natural disaster destroys access to cell phone and TV signals.

"AT&T and everybody else were overwhelmed, but we were able to set up satellite communications," McCreary said. "We used a dish to tap into our main network back in St. Louis. That allowed us to set up computers and access medical records. That was important to helping us set up the mobile hospital on the parking lot."

Argument For Electronic Records

McCreary says the storm added to the argument for investing millions of dollars to develop electronic records. Like other hospitals and health systems, Mercy qualifies for federal stimulus money for shifting to electronic records.

"But we started this without the idea of stimulus money," McCreary said. "We did it primarily as a way of improving patient care. We're now in the top 3 percent of hospitals nationwide in converting to electronic health records."

He says the other big lesson is that, stimulus money or not, it made sense to convert to electronic records.

"When you're doing disaster planning, there's always a cost-benefit analysis. But if there was any doubt about the worth of investing to prepare for a disaster, this has shown the worth," McCreary said. "If you have that data in an electronic format in a secured site, you can get back to normal much quicker after a disaster."

Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.

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