The recent disaster in New Orleans 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., hopes 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.
"Like most physicians, I have billing electronic records, but my office clinical records are paper. I assume all thatand our supplies and equipmentwill be unsalvageable," he said in an interview shortly following the flood.
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.
Some electronic records weren't able to be accessed as most computer servers have been destroyed, Ms. Shirley said. 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. "And, it does not have to be a vendor you bought your software from; there are tons of vendors out there providing remote access."
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 (and only about 15% of doctors have them), physicians should consider storing their administrative records, such as financial and scheduling information 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. So securing your financial records is equally as important." 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 be reopening 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, Dr. Ellis was able to communicate only by e-mail because all the phone prefixes in Louisiana and Mississippi were unreachable.
He could reach his practice associate in Birmingham via e-mail. "Two of my staff communicated that they are in upper Mississippi," he said. Other physicians e-mailed from Houston and Baton Rouge to let him know their whereabouts.
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.
FEMA Floodproofing Tips
Here are some general tips from the Federal Emergency Management Agency on flood and hurricane preparation for businesses:
▸ Ask your local emergency management office whether your facility is located in a flood plain. Find out the history of flooding in your area. Determine the elevation of your facility in relation to streams, rivers, and dams.
▸ Learn about community evacuation plans from your local emergency management office.
▸ Establish facility shutdown procedures. Make plans for assisting employees who may need transportation.
▸ Purchase a National Oceanic and Atmospheric Administration weather radio with a warning alarm tone and battery backup. Listen for flood watches and warnings.