cording to Clark, but there is no way to recreate them.
“If any lost records contained information from our source
systems such as lab or x-ray reports we should be able to recreate that part of the health record once our patient registration
system is restored,” she says.
Freeman Health System’s Story
Across the street from St. John’s, Freeman Health System suffered only minor structural damage. It cared for the majority of
the patients in the area following the disaster, receiving 1,000
patients in the first 24 hours, relates Julie Dooling, RHIT, a practice resource manager at AHIMA who visited Joplin-area hospitals several weeks after the tornado.
Despite a lack of damage, the first 36 hours at Freeman were
difficult. A large number of patients were being brought to the
hospital, which was running on emergency generators. The EHR
system was never down, but staff resorted to paper. The generators were needed to power essential equipment, and there were
not enough PCs and mobile workstations to manage the initial
influx of patients.
Help, however, was not hard to find, as even physicians who
were driving through the area stopped and worked alongside Freeman physicians, attending to patients, says Donna
Caldwell-Chaffin, RHIA, CCS, assistant director of medical records at Freeman.
Nonclinical staff rushed to help as well. Hospital staff who
would normally assist with gathering patient information in a
disaster situation were instead redirected to assist in caring for
the large influx of patients, according to Caldwell-Chaffin.
“One of our transcriptionists was helping radiology techs that
were shooting x-rays. She was wiping blood off the metal film
cases as fast as she could so they could shoot more films,” she
says. “Our hospital attorney was working in the ambulance bays
that night. Our normal workforce for a typical evening was about
400. That night we had an estimated 888 Freeman employees re-
port to work.”
Caldwell-Chaffin says up to 100 additional nonclinical staff
also volunteered their services at the hospital. But even with ex-
tra hands, documentation was difficult to obtain due to the cha-
otic nature of the situation. Joplin is on the border of Kansas and
Oklahoma, so it was even possible that members of the same
family were taken to facilities in different states.
“Documentation was not what we would have liked to see,
but in this situation it was life and death, and treating patients
became top priority,” Caldwell-Chaffin says.
“The massive volume of patients made it very difficult to provide ‘good’ documentation. Clinicians were trying to treat the
less critical patients and move them out so that others could receive care,” she says.
Adding to the confusion, Caldwell-Chaffin says, “truckloads”
of people were coming to Freeman’s registration area, but often
the names being documented were not those of the patients,
they were names of family members or friends. “So when it
came time to account for the dead and missing, these lists were
Permanent Record
The HIRO Fund
HIM PROFESSIONALS IN areas affected by disasters face
a unique challenge as they struggle to piece back together
their own lives while working to recover as much of their
community’s patient information as possible.
In their support, AHIMA, through the AHIMA Foundation,
has established the Health Information Relief Operation
(HIRO) Fund to assist communities of health information
professionals whose personal
or professional lives have
been severely disrupted by a
natural or man-made disaster.
The HIRO Fund will provide immediate material relief
made possible through an initial $10,000 donation from AHIMA and the generosity of AHIMA members and the greater
health information management professional community.
Online donations to the fund may be made at https://se-cure.ahima.org/fore/donations/donatorinfo.aspx. (Select the
HIRO Fund from the dropdown menu titled “Donation Type.”)
To make a donation by mail, send a check indicating the
HIRO Fund designation to: AHIMA Foundation, 25351 Network Place, Chicago, IL 60673-1253.
not reliable,” she says.
The legal ramifications that could have arisen from misidentified patients were waived when the Federal Emergency Management Agency declared Joplin a disaster area.
At the time of her visit, Dooling notes, both St. John’s Regional
Medical Center and Freeman Health System were working with
local physician offices to match records and obtain insurance
information so that bills could be dropped.
“However, physicians in the community not only lost their
hospital, but in some cases their offices and even their homes,”
she says.
Within several days of the tornado Health and Human Services Secretary Kathleen Sebelius declared a public health
emergency in Missouri and authorized waivers of certain Medicare, Medicaid, CHIP, and HIPAA requirements under section
1135(b) of the Social Security Act.
“The disaster in Joplin could have been an entirely different
story if both hospitals had not made a decision many years
ago to start their EHR journey by first converting paper into an
electronic format by using a document imaging system,” Dooling notes. “In addition, St. John’s recent EHR implementation
combined with a sound information technology disaster recovery plan and support from their integrated healthcare delivery
system added positively to the recovery efforts.” ¢
Matthew Russell ( m.s.russell@gmail.com) is a freelance journalist based in
Grand Rapids, MI.
