The recent disaster in the Gulf Coast may be a wake-up call for all physicians to establish some kind of emergency backup system for their businesses.
“Physicians don't always think of themselves as running a business, but they're going to think of it now,” Rosemarie Nelson, a Syracuse, N.Y.-based consultant with the Medical Group Management Association, said in an interview.
Otolaryngologist Michael Ellis, M.D., is hoping that technology might have retained some of his records. His practice in Chalmette, La., south of New Orleans, is in an area flooded to the rooftops in the aftermath of Hurricane Katrina and the subsequent breakdown of New Orleans' levees.
Dr. Ellis said that he had backups in place for his billing records, both hard copy and “off campus” (outside computer services), assuming that certain computers weren't damaged or backed up during the flood.
As Ms. Nelson noted, “there is just no way to secure paper records. They're there or they're not. You're not going to copy and store them off-site.” However, a fully integrated electronic medical record might not have been completely safe for stricken medical communities, either.
Anne L. Shirley, a spokeswoman with the Louisiana State Medical Society, said an undetermined number of records have been destroyed.
The Louisiana State Board of Medical Examiners is located in a hard-hit flood area in New Orleans, and the society's Web site and database were inoperable, even from remote locations, Ms. Shirley said. “This, as you can imagine, poses a problem with license verification and credentialing for displaced physicians.”
One way to solve backup problems such as these is to have electronic medical records stored in a secure, remote site by a vendor, Ms. Nelson said.
Such vendors also can offer Internet-based backups, which “add a whole new sense of security,” she noted. “When something happens in an area or region, that [backup disk] you took home is as insecure as your records.”
Even if they don't use an electronic medical record system, physicians should consider storing their administrative records off-site, Ms. Nelson said.
“You need to think about using off-site backup for your financial applications, scheduling, patient list, and some receivables. You still have insurance receivables there, and you're going to need that cash inflow because you're going to have to buy new equipment.”
The patient list will be essential when you need to inform patients that you've set up your practice in a new location or will reopen on a particular date, she added.
An advantage of backing up financial information is that it also includes some clinical information, Ms. Nelson said. “That's because you need to have a diagnosis code to bill the insurance company.”
At press time, the Louisiana State Medical Society was working with the state's Department of Health and Hospitals, the Office of Emergency Preparedness, the Department of Homeland Security, and the Federal Emergency Management Agency to contact physicians.
Medical Schools Find Interim Quarters
Medical schools affected by Hurricane Katrina and its aftermath scrambled to find alternative locations and resources, to ensure that their students and residents would be able to continue practicing medicine.
At press time, most of the students from Tulane University in New Orleans were being housed 180 miles away at Jackson State University in Jackson, Miss. Tulane leadership had set up temporary headquarters in Jackson with the assistance of the University of Mississippi Medical Center.
Paul K. Whelton, M.D., senior vice president for health sciences at Tulane, said the university would establish a more permanent “interim leadership headquarters” in Houston.
“Senior administrative staff are in discussion with their counterparts at Houston-area medical schools about these schools assisting Tulane in continuing to provide medical education for Tulane students in all 4 years of medical education,” the Association of American Medical Colleges reported. A similar plan was being developed for Tulane residents.
In the meantime, the School of Medicine at Louisiana State University, New Orleans, made arrangements to hold classes in Baton Rouge until its facilities were once again suitable for occupation.
Charity Hospital in New Orleans will be out of service for an extended period of time, as the city begins a major clean up effort, he said. “We will be expending our bed capacity at Earl K. Long Medical Center [in Baton Rouge], and at University Medical Center in Lafayette … and reassigning our residency staff to those hospitals as well as to some other private hospitals.”