The impact of hurricanes: 5 questions with Schneider Regional Medical Center CIO Cameron Aust on paper charting, water-damaged tech

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Two Category 5 hurricanes slammed the U.S. Virgin Islands in September, stripping off roofs, knocking out power and flooding streets.

Schneider Regional Medical Center, the only hospital on the island of St. Thomas, which is part of the U.S. Virgin Islands, hardly made it through the storms. It lost a section of its roof, shut down its entire cancer center and suffered a drastic decrease in patient volume, affecting staffing, revenue and the range of services available. Caregivers at Schneider were without the EHR off and on for weeks, and water damage plagued legacy paper charts.

"The reason the hospital came through as well as it did — because we did take a significant amount of damage to the physical structure of the building — is really due to the dedication of a great many of the staff here," says Cameron Aust, CIO of Schneider Regional. "There were people that were living here in the hospital for eight to 10 days at a stretch, in very, very poor conditions, environmentally."

Now, nearly five months later, Mr. Aust estimates the hospital is operating at around 40 to 50 percent functionally.

Schneider is primarily a Meditech EMR customer, but does use some products from other vendors, too, says Mr. Aust. Though the hospital never lost power for an extended period of time, its EMR was only turned on about every three days to avoid over-running the generator or compromising the system. During the times the EMR was being rebooted, Schneider's healthcare providers worked on overdrive to input and extract the necessary data from the system.

Becker's Hospital Review recently spoke with Mr. Aust about the hospital's post-storm challenges, the damage to its data center and how its healthcare providers adapted to working with limited access to its EMR.

Note: This interview was edited for length and clarity.

Question: Power was knocked out across the island. Did the storm affect the hospital's need for electricity?

Cameron Aust: We have a fairly good generator system here and it actually powers the entire facility. There is also a rather large uninterruptible power supply system in the data center that is good for about 90 minutes. We never actually did lose power, but we did lose access to our data center when the roof blew off of the section of the hospital where it is located, and water started pouring in through the ceiling. We had to shut down everything and reconnect to power to salvage the equipment at all. So, although we did have power in the hospital, we were without our EMR off and on for about three days at a time.

Q: What did physicians do to chart patient records?

CA: Basically, we rolled through our regular downtime procedures for these interruptions, and as we got some sort of break in the weather, we could actually get enough of the water out of our data center and prevent it from hitting the equipment. Every three days, we would bring everything back up for about a day to allow everyone to input their paper chart material and get all of the patient records caught up. We also used this time to extract various types of patient data our cancer center required to transfer radiation therapy patients. Even before the storm, we still had a great deal of paper charting going on here. Frequently, physicians do the actual recording of patient information on paper, and then transfer if to the EMR later.

Q: Were any paper records damaged as a result of the storms?

CA: We had quite a bit of damage to paper products in various offices but not significant current patients' information. Virtually all of our [legacy] medical records are in paper form and the medical records office is right next door to mine, so when our area had water coming through the ceiling, their area did too.

Q: How did the storm affect other devices and equipment?

CA: We had a significant amount of water in the data center. We were very fortunate we didn't really take any serious damage to our network equipment, and we did not experience any sort of data loss. But, we lost about 25 percent of our desktop equipment — PCs, monitors, printers, things like that — because people could not move those fast enough when the building itself started taking damage. However, we were able to power down our network systems, so even if they did get a little bit too much humidity, there was no power to them so they didn't face much damage. For the most part, if we could bring our internal network up — even if we couldn't get internet connectivity — all of the network devices functioned as long as there was power, including all of their standalone devices like infusion pumps. Physicians weren't without their critical equipment for any extended period of time.

Q: How are you, as CIO, helping the hospital recover?

CA: Our most significant challenge is we had many projects in process — we were working on becoming meaningful use compliant, working on EMRs, establishing bedside bar-coded medications, integrating computerized physician order entry — but with the evaporation of our funding amid the storms, all of that stuff is on hold. Right now, we are focusing on simply keeping everything functioning. We are scavenging equipment out of the damaged areas, refurbishing it as we can, relocating people and reallocating equipment to make the most effective use out of it. Basically, we are trying to make sure everything keeps functioning.

The hospital is still seeking medical supplies and monetary donations to mitigate the devastation. Please contact Shanique Woods Boschulte at 340-227-3557 if you are interested in donating.

This story is part of a weekly series chronicling Schneider Regional's journey through the hurricanes, the damage it experienced and its efforts to rebuild.

Click here to read the remarks of Schneider Regional Medical Center CEO Bernard Wheatley, DBA. 

Click here to read the article featuring Schneider Regional Medical Center CMO Luis Amaro, MD.

Click here to read the article featuring Schneider Regional Medical Center CFO Scott Nothnagel.

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