Electronic communications and cloud-based tools helped healthcare providers in Texas deliver patient care before, during, and after the storm.
The nation's focus shifted to Hurricane Irma and Florida over the weekend, while the city of Houston and a huge swath of Texas was still cleaning up from the devastation of Hurricane Harvey.
Dan Jenson, CFO of VillageMD-Houston, shared how his organization used technology to prepare for the storm, keep in touch with patients as Harvey hit, and to get back on its feet in the aftermath.
VillageMD is a physician services company that partners with independent primary care physicians and health systems for value-based care.
In Houston, it partners with Village Family Practice, a city-wide network with 11 clinics and more than 100 affiliated doctors. After the storm, only one of those clinics had major flooding.
Nine of the clinics were operational by Thursday, August 31 (the storm made its first landfall on August 25).
Before the Storm
As Harvey approached, the clinic staff considered all scenarios—lost power, downed phone lines, no internet access—to determine how patients could stay in touch with physicians throughout the storm. They then communicated those plans to patients.
"We thought the best thing to do—beyond making sure our property was secure, [was to make sure] our IT systems were as secure as possible—was to make sure that we did as much communication before the storm hit to make sure that our patients knew who to call, what phone lines would be available to reach out physicians," Jenson says.
In its day-to-day operations, the clinics used their Athenahealth portal to send communication campaigns out to specific cohorts of patients.
The problem, though, was that the portal only had the capability to reach 10,000 patients at a time. As they prepared for Harvey, the clinics needed to reach more than 150,000 patients.
So they contacted athenahealth to explain their predicament.
"The Wednesday before the storm, we actually phoned Athena," Jenson says. "Athena was able to, literally overnight, create a solution, and we were able to send out mass campaigns to all of our patients."
That mass campaign included a phone call, a text, and an email that let patients know the storm was coming, the phone numbers they would need to contact the clinics, and emergency information outside of medical care.
The campaigns also told patients to keep an eye on the clinics' website and social media for additional updates before, during, and after the storm for clinic openings.
Care managers also reached out personally to high-risk patients and those who needed special assistance, such as oxygen or dialysis. They were given storm information and a reminder that on-call physicians would be available by phone during the storm.
Reaching Patients
"Most of the feedback we heard was that those patients—who were mostly elderly patients—felt very comforted by knowing that someone proactively called," Jenson says.
"That someone was thinking about them and they felt they knew they had a line if things were getting to a place where they felt they needed medical assistance."
Letting patients know that they could call a primary care physician during the storm was a way to prevent incoming calls from "clogging up emergency lines that were obviously dealing with much more critical situations."
The clinics were not open during the storm and through the Wednesday after, but because its EMR is cloud-based, any caregiver could access medical records via their laptops, either with Wi-Fi or without, thanks to the athenahealth mobile app.
"We had on-call physicians throughout the storm taking calls," Jenson says. They not only helped to treat and triage patients, but also offered voices of comfort to patients and made them feel less alone.
The Aftermath
Harvey pelted the city with rain for days, and the cleanup is ongoing; flooding, road closures, and environmental hazards such mold and mosquitos are at play.
Some patients have been injured during their cleanup and rebuilding efforts.
There's also a pent-up need for medical care, thanks to closed or inaccessible clinics; Village Family Practice has been doing extended and weekend hours, as well as seeing other providers' patients and working to host some of those other providers in their space.
They're reaching out again to patients via a program called Village at Home, which sends providers into patients' homes.
Normally the service focuses on patients who are home-bound or otherwise can't get into a physicians' office, but now those visits are also assessing patients' home environments post-storm and referring a social worker, if needed.
"At times like this after a storm and major flooding this has been a very beneficial thing for our providers to be able to take an iPad, access the medical record and go into the home of a patient," Jenson says.
Continuing to Communicate
Although staff are still debriefing about how they could have done better before and during the storm, the clinic team already has some lessons learned, such as the need for a post-storm plan to get staff mobilized in the aftermath.
For instance, flooding and road closures have made it difficult for some staff to get to work, but shared spreadsheets have helped see who is staffed where, and a global medical record system allows providers to care for patients from any clinic.
Another mass campaign after the storm let patients know that the clinics are operational, accepting walk ins, and even double and triple booking appointments to make sure everyone gets seen. They're also communicating with patients about possible post-storm health hazards to look out for.
More than anything, Jenson praises the staff for their dedication to patients.
"In situations like a natural disaster a lot of industries will sit down and think about their business needs," he says. "I think it's less about the business needs and more about the needs of our patients."
Alexandra Wilson Pecci is an editor for HealthLeaders.
