Phased approach to info sharing during disasters is superior

A phased approach to incorporating health information exchange (HIE) into disaster preparedness efforts will be helpful, according to the findings published in the final report from the Southeast Regional HIT-HIE Collaboration (SERCH) project on Health Information Exchange in Disaster Preparedness and Response.

The Office of the National Coordinator of Health IT (ONC) convened SERCH in November 2010, to develop a strategic plan for sharing health information data among the Southeast and Gulf states during and following a declared natural disaster.

The consortium behind the project included representatives from Alabama, Arkansas, Florida, Georgia, Louisiana and Texas. The consortium members assessed the challenges of accessing medical records and coordinating healthcare information for patient populations displaced due to a disaster. This process included a detailed legal analysis to determine what laws impact HIE during a disaster and whether different protections apply in the event of a declared disaster.

The consortium assessed the current and planned technical infrastructure in the participating states with the goal of incorporating disaster planning earlier with HIE projects. The consortium also considered what related governance issues would need to be resolved prior to a disaster, including delegation of authority, resource allocation and management, and continuity in the event of changes in state or local government leadership.

The phased approached suggested by SERCH supports immediate progress in the absence of routine, widespread HIE, and addresses legal, technical and governance issues and offers a list of steps that states can take to align their HIE planning activities with ongoing emergency preparedness activities.

The SERCH report offers the following five recommendations:

  1. Understand the state’s disaster response policies and align with the state agency designated for Emergency Support Function #8 (Public Health and Medical Services) before a disaster occurs.
  2. Develop standard procedures approved by relevant public and private stakeholders to share electronic health information across state lines before a disaster occurs.
  3. Consider enacting the Mutual Aid Memorandum of Understanding to establish a waiver of liability for the release of records when an emergency is declared and to default state privacy and security laws to existing HIPAA rules in a disaster. States should also consider using the Data Use and Reciprocal Support Agreement to address and/or expedite patient privacy, security and health data-sharing concerns.
  4. Assess the state’s availability of public and private health information sources and the ability to electronically share the data using HIEs and other health data-sharing entities.
  5. Consider a phased approach to establishing interstate electronic health information-sharing capabilities.

“Taken together, these recommendations offer a path forward for other states that wish to integrate disaster planning and health information exchange efforts,” said Lee Stevens, program manager at the Department of Health & Human Services, writing on the ONC’s HealthITBuzz blog. “Combining these two important health care functions will help ensure that when a disaster strikes, patients and providers will have better access to information and providers will be better able to provide appropriate care.”

The entire report is available on the ONC's website.