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The Tornado and a Patient’s Electronic Health Record (EHR)

Emergency in Joplin

Computers on mobile stands

Computers gathered for accessing patients’ electronic health records at the mobile field hospital that substituted for the St. John’s Regional Medical Center, which had been severely damaged by the tornado in Joplin, Missouri. Photo by Aaron DuRall - DuRall Photography.

When the tornado hit Joplin, Mo., back in May, St. John’s Regional Medical Center evacuated its patients, triaged at a community hall, a high school cafeteria and other nearby locations, patched up the most urgent of the injuries from flying glass and debris and then set about to redistribute the patients to hospitals many miles and states away.

Paul Johnson, 78, suffering from pneumonia, was very specific: “Take me to Springfield.”

“They were taking people everywhere: Oklahoma, North Arkansas, Kansas City.  I wanted Springfield,” Johnson recalled.

Wearing only a hospital gown and shorts -- no shoes—finding his way down a dark stairwell and hallway as “my niece kicked stuff out of the way” and worrying about his injured wife and other family members who had been visiting him when the tornado struck, Johnson had the presence of mind to ask for St. John’s Hospital in Springfield, Mo. His reason: His electronic health records (EHR) would be accessible there.

St. John’s Regional Medical Center had just transitioned from paper to EHRs three weeks before the tornado, joining its sister hospitals, part of the Sisters of Mercy Health System, which had already moved to the electronic age in medical records.  

“We wanted to make sure they had our records. If I was asked what my medications were, what tests I had, how could I answer?” Johnson said.

The Recovery Act Helps Medical Professionals Go Electronic

One of the Recovery Act’s signature initiatives is an effort by the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology to encourage health care providers and hospitals to make the transition from paper records to certified EHRs in order to improve health care and control costs.  CMS projects that nearly $18 billion will be paid in Medicaid and Medicare incentive payments nationwide from 2011-2021 to eligible health care professionals and hospitals that adopt and meaningfully use certified EHRs.

All of the Mercy hospitals have registered for the Medicare EHR Incentive Program. As of Sept. 12, two of the Mercy hospitals in Oklahoma have already received Medicaid incentive payments, and St. John’s in Joplin –now a temporary modular facility—and St. John’s Mercy in Washington, Mo., have been approved by the state for incentive payments.

Smoothing Transitions for Patients in Medical Emergencies

St. John’s experience with the tornado is a prime example of why EHRs are important. Paper charts and x-rays were reported found strewn in peoples’ yards 75 miles away near Springfield. Others undoubtedly were destroyed. But St. John’s EHRs were available immediately to doctors at its sister hospital in Springfield, allowing for as seamless a transition as possible for patients under such emergency conditions.

“The doctor at the emergency room had my records right up there,” Johnson said.

For Johnson, a smooth transition in care was particularly important. He needed treatment for the cuts and bruises he suffered from the tornado, but he also had had a biopsy the day before the tornado when his doctors suspected something more than just pneumonia. The Springfield doctors got the lab results and confirmed the test: He had lung cancer. They treated him for several days until he could return to the care of specialists at the mobile hospital in Joplin.

Patient and Hospital Recovery in Joplin

Seven days after the tornado, St. John’s became a mobile field hospital, a tent-like structure at which doctors could access patients’ EHRs. But the EHRs were available within 48 hours of the tornado at Memorial Hall, the Joplin community venue that was used first for triage and then as a temporary clinic site for nearly 35 physicians whose offices had been destroyed in the storm. The EHRs could have been accessed earlier, but Mercy Technology Services had to purchase the necessary satellite equipment, a Mercy spokeswoman said.

Johnson and his wife, Lavonne, celebrated their 58th wedding anniversary while he was in Springfield. Despite his illness, he says, “I’m blessed.” The injuries to his wife and family were minor, as was the damage to his house. He ticked off: “My car, my wife’s car, my son’s car and my brother’s car were destroyed.”

Nonetheless, Johnson said, “I’ve had so much support; I’m not letting it get me down.”

Postscript: St. John’s has begun moving from the mobile field hospital to a hard-sided modular facility and seeing patients there. Mercy announced recently that it will rebuild in Joplin, with plans to break ground in January 2012 and to open a new state-of-the-art hospital in 2014.

For more information about the Recovery Act’s Electronic Health Records initiatives, see: