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Calm during the storm: How interoperability helped hospitals during the hurricanes

I joined a large gathering of industry experts in Washington D.C. for the 2017 annual meeting of The Office of the National Coordinator for Health Information Technology (ONC). This year’s event featured a panel that included patient and clinician perspectives alongside healthcare and innovator points of view on the subject of interoperability. 

Jim Jirjis, M.D., Chief Health Information Officer at HCA Healthcare, shared two compelling stories about what interoperability means in the middle of a crisis. I think these examples are best shared in his own words, which you can watch in the last 10 minutes of this video, or read in a transcript* of his remarks below:

“Fifty percent of our hospitals are in either Florida or Texas and a couple of big things happened lately in Florida and Texas….in the middle of a crisis, do you want people running around with clipboards trying to find metadata? I’ll tell you what we learned with each hurricane. The first hurricane that hit Texas, what we found was, because of all the work we had done with semantic interoperability and the viewer in the workflow, we had to evacuate patients from many of the hospitals we had to close. And we had to receive them in our other hospitals…

“So the story of a woman who was pregnant: She came to one of our hospitals in Texas and went into labor. She had a premature infant on life support in the NICU. And then that day, the hurricane hit. And that’s a hospital we didn’t open, that’s permanently closed because of the hurricane. We had to transport her, and the nurses that were receiving her, it was like they had one record. All the blood cultures, and all of the data not only was available, but was available and graph-able and plot-able as if it was one hospitalization. Can you imagine if that was the future? … If the information and its meaning actually followed the patients wherever they went?

“The second example was in Florida…We had the hurricane coming, and we didn’t know where it was going to move. We had these command centers with leaders of the company and others saying we need to get people…in the middle of a crisis to take clipboards and figure out which patients for transport are too heavy for a helicopter or on a ventilator or on an insulin drip…because if a helicopter shows up to pick up a patient and they can’t get on it because they’re on a ventilator and you didn’t tell them, that helicopter leaves empty…So they started going down the path of clipboard stuff and we said, ‘Time out. Give us two to three hours.’

“The team went back, and because we had all of that structured data for all of those elements…A couple hours later they came back with a spreadsheet with each hospital in Florida having a tab where you could drill down to the patient level, and it said who was ambulatory could get on a bus, who was too heavy for a helicopter, who was on drip, and we had it for all 30 or 40 hospitals in Florida because we didn’t know where the hurricane was going to go… so let’s take our sickest patients, the ones you don’t want to be moving in a hurry, and let’s move them now, and we knew who they were and we transferred them first….

“The dividends keep on coming. Could you imagine that if beyond HCA – our communities and FEMA – if they all had the ability to understand the needs of the populations at risk and could move on it? That’s powerful.”

These were exceptional circumstances, and HCA employees are clearly exceptional people who rose to the challenge. We’re grateful to partner with this team that puts patients first.

* Edited slightly for length and clarity.

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