Hurricane Irma: Digital Health Infrastructure Faces Another Extreme Stress Test

Florida hospitals are offering free telehealth, but concerns about interoperability abound in the state with the US's largest elderly population.

Hurricane Harvey proved both a devastating tragedy and an intense stress test of America’s increasingly digitized healthcare infrastructure. With Hurricane Irma menacing the entirety of Florida, a repeat may be imminent.

Tens of millions of Floridians, and hundreds of hospitals sit directly in the storm’s path, it is doubtless that a hospitals and their IT infrastructure will be put to the ultimate test for the second time in as many weeks. To make matters worse, Florida has the highest proportion of residents over the age of 65 of any state, again elevating the likely demand for medical attention.

Several Florida hospitals announced today that they’d be offering free telehealth services between now and Monday, the Orlando Sentinel reported this afternoon. Florida Hospital, Nemours Children’s Hospital, and Orlando Health will open their services via their websites or apps to those with “minor illnesses and injuries.” Nemours also offered their remote services to Texas through their CareConnect system in Harvey’s wake.

Displacement can lead to great confusion in America’s often-siloed health system. The good news is patients are a lot less likely to have their medical records destroyed altogether, as happened during Katrina, since most providers today now store health records electronically. There’s still a risk of loss, however, if those records aren’t backed up remotely in the cloud. Plus, the industry isn’t yet interoperable to a point that difficulties are avoidable.

With closures and evacuations, many patients in Texas ended up in out-of-network facilities that did not have immediate access to their EHRs. Dan Jenson of the VillageMD Network in Houston told Wired that, for such patients, “We can try to pull data on some of them, but it’s very limited what we can get. A lot of times we have to start from scratch.”

That article goes on to highlight the Patient Unified Lookup System for Emergencies, or Pulse, program that just finished its pilot stage in California. The Office of the National Coordinator for Health IT initiative would allow disaster and healthcare workers to tap into all patient records in a region, only in times of emergency. Such a program is still likely some ways from national implementation.

Still, according to a Bloomberg BNA article, EHRs prevented such headaches from being worse than they could have been.

Some companies are attempting to make things easier in times of crisis. Surescripts and Allscripts paired to make patient-specific history and data more available to pharmacists in Louisiana and Texas “for a limited time.” In the case of a federally-declared public health emergency, the Department of Health and Human Services is able to waive some HIPAA privacy provisions to make such allowances possible. The joint statement from the two companies read that “The organizations are also watching Hurricane Irma and considering response options should the situation deteriorate and require similar support.”