Hurricane Michael - Disaster Response Resources

Flood-Damaged Medical Records

Many healthcare facilities and physician offices will be trying to recover and restore water-damaged paper and electronic records over the next weeks and months in the aftermath of Hurricane Michael. Before investigating potential damage to medical records:

• Make sure the PHI storage location is safe to enter.
• Call your general liability/property insurer for directions and recommendations.
• Execute business associate agreements with any vendor hired to help recover PHI.

Paper Records

The best thing for wet records is to handle them as little as possible and keep them from molding. Mold starts to grow quickly — within two to three days — so it is important to take action as soon as possible. In the meantime:

• Reduce the temperature and humidity and increase the circulation in the record storage area.
• If a professional document drying company cannot be contacted within 48 hours, place the records in a freezer.
  
  • Start with the wettest documents.
  • Do not open or clean the records.
  • Pack records tightly to avoid movement during transport.
  • Do not thaw the records without obtaining professional advice.

Document Drying/Restoration Resources

• AAFP: Recovering Flood-Damaged Records
• Conservation Center - National Resource Guide for Disaster Preparedness (PDF)
• National Archives: Emergency Salvage of Flood Damaged Family Papers
• Interstate Restoration – Quick Guide to Recovering Damaged Paper Documents and Books (registration required)

FLOOD-DAMAGED ELECTRONIC DRIVES & DEVICES

The National Archives and Records Administration and DriveSavers Data recovery make the following recommendations for managing water-damaged hard drives and devices:

• Don’t panic. Data can be recovered from water damaged drives and devices; however, the more quickly work can start on the data recovery, the greater the likelihood of success.
• Do not attempt to turn the drive/device on, which can make things worse.
• Do not rinse drives/devices in clean water.
• Send the drive/device to a data recovery service. If the device is battery-powered, remove the batteries before shipping. Leftover charge in the battery can increase corrosion.
  
  
  • Pack drives/devices well in boxes twice their size so they do not move or come in contact with other devices during shipping.
  • If the device/drive is wet, place it in a sealed container to maintain moisture. This keeps the components from further corroding.
  • If the device/drive has already been dried, do not put extra water in the sealed container.
  • Do not put your device/drive into a drying agent such as rice or cat litter.
  • Handle the device as little as possible.
    
    

For more information, visit the company’s website at www.drivesaversdatarecovery.com.

Flood-Damaged Electronic Drives and Devices Resources

• DriveSavers Disaster Preparedness Data Safety Tips
• National Archives: Electronic Media – Hard Drives
• DriveSavers Data Recovery: Data Safety Advice for Hurricane Victims

FLOOD WATER REMOVAL

There are a number of vendors that remove flood water from business properties. Contact your general liability insurer in case it has a preferred contractor.

Medical Information Privacy

The HIPAA Privacy Rule is not suspended during a public health or other emergency.  Last month, during Hurricane Florence, the Office of Civil Rights (OCR) released the following guidance for the appropriate sharing of medical information during a hurricane. Additional information may become available on the OCR website.

OCR Issues Guidance – Sharing of Medical Information during Hurricane Florence

Hurricane Florence and HIPAA Bulletin: Limited Waiver of HIPAA Sanctions and Penalties During a Declared Emergency (PDF)

The following information may be helpful in preparing for requests received during or after a natural disaster or state of emergency:

• AHIMA: Complying with the Privacy Rule during a Disaster Part 1
• AHIMA: Complying with the Privacy Rule during a Disaster Part 2
• HHS.gov: Emergency Situations: Preparedness, Planning and Response
• HHS.gov: Disclosures for Emergency Preparedness – A Decision Tool: Overview

Reconstructing the Medical Record

If you cannot salvage the medical records or otherwise reconstruct them via electronic data recovery, you should re-create them to the best of your ability. Approach the various other entities that are storing your patients’ PHI in their own databases and record-keeping systems. For example, pharmacies, consultants, prior treating physicians, third party insurers, transcription services and hospitals most likely have PHI they can provide. The following strategies can facilitate the reconstruction process:

• Inform patients in writing of their PHI destruction.
  • Include the date and circumstances.
  • Describe attempts to reconstruct their records.
  • Send the patient a history form.
  • Invite the patient to contact you to provide additional information.
  • Keep a copy of the patient record in the patient’s new file.
• Date the reconstructed record with the current date.
• Identify the record as reconstructed PHI so there is no question as to whether the record is reconstructed or original.
• Contact third party insurers as soon as possible to determine whether they require attestation forms.
• Notify your State Board of Medicine of the approximate number of records that were lost or destroyed in the hurricane and what actions have been taken in your restoration and reconstruction effort.
  
  

Documentation of the Destruction

Document the PHI record/data damage and your recovery efforts, including:

• Describe the event (date, severity, duration, etc.).
• Describe the loss of PHI.
  • Construct a log of damaged or destroyed records.
• Include photograph/video records of the damage and copies of property insurance claims documentation.
• Describe efforts to reconstruct PHI.
• Enter a description of the event and reconstruction efforts into reconstructed patient records, which should include what has happened specifically in that patient’s case — e.g., that a letter was sent with a health history form, that conversations took place with the patient/family in efforts to reconstruct the record, etc.

If affected PHI is requested, include documentation of PHI damage and recovery efforts with your response to the PHI request. 

The information provided on this website is intended as risk management advice. It does not constitute a legal opinion, nor is it a substitute for legal advice. Legal inquiries about topics covered on this website should be directed to an attorney.

Reference herein to any specific product, process, service, or entity does not necessarily constitute or imply the endorsement, recommendation, or favoring by the NORCAL Group of companies.

General Information Resources for HEALTHCARE PROVIDERS

• DHS Ready Check Hurricane Readiness Checklist
  
  
• DHS Ready Preparedness Planning for Your Business – Toolkits
  • Ready Business Hurricane Toolkit (PDF)
  • Ready Business Inland Flooding Toolkit (PDF)
  • Ready Business Power Outage Toolkit (PDF)
    
    
• HHS TRACIE – Healthcare Emergency Preparedness Information Gateway
  
  
• TRACIE - Hurricane Resources at Your Fingertips (PDF)
  
  
• HHS – Public Health Emergency Resource for Professionals
  
  
• US Department of Labor OSHA Hurricane Preparedness and Response
  
  
• CDC Post-Hurricane Safety Advice for Healthcare Professionals
  
  
• DAShealth – Is Your Practice Prepared for Hurricane Season? A Practice Checklist
  
  
• American Red Cross – Special Needs Emergency Preparedness – app download available
  
  
• American Red Cross – Find an Open Shelter
  
  
• Preparis Hurricane Toolkit (registration required)
  
  

Alabama

• Alabama governor declares state of emergency as Michael nears
  
  
• Alabama Emergency Management Agency – Be Ready
  
  
• Alabama Emergency Management Agency - LIKELY MAJOR HURRICANE HEADING TOWARD GULF COAST
  
  

Florida

• State of Florida Division of Emergency Management
  
  
• State of Florida Division of Emergency Management disaster planning
  
  

Georgia

• Georgia Emergency Management & Homeland Security Agency
  
  
• Ready Georgia (mobile app available)
  
  
• Georgia Department of Public Health
  
  
• Emergency Preparedness Toolkit for Primary Care Providers
  
  

South Carolina

• South Carolina Emergency Management Division
  
  
• South Carolina Hurricane Guide
  
  

North Carolina

• Ready NC – Hurricane Preparedness
  
  
• North Carolina Department of Public Safety – Hurricane Florence 2018
  
  
• NC State Extension – Hurricane Preparedness: Plan Ahead to Prevent Wind and Water Damage