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    Starting with the February severe winter storm in Texas that killed more than 200 people and caused more than $20 billion in damage, there have been dozens of declared natural disasters thus far in 2021, with hurricane season for the Atlantic ongoing.
    A Sept. 14 MGMA Stat poll found that 18% of medical practices were affected by a natural disaster this year. That poll had 791 applicable responses. A similar MGMA Stat poll from Nov. 10, 2020, found 18% of practices were affected by a natural disaster last year.

    Who’s coming to the rescue?

    Some storm systems of concern didn’t inflict the extent of damage expected; Hurricane Ida — the second major hurricane of the 2021 season — did not break New Orleans’ levees, but it did knock out power throughout the city and would eventually spawn a series of storms and floods across the United States that resulted in 95 direct and indirect deaths.

    This follows a historic wildfire season in the American West and a resurgence of COVID-19 cases, which has prompted concerns from some Federal Emergency Management Agency (FEMA) officials about the ability to adequately meet demand if the pandemic and natural disasters keep up their worrisome pace.

    As POLITICO reports, “there is growing concern … that state governments' dwindling capacity to continue responding to devastating natural disasters as well as spikes in COVID-19 cases could put more pressure on FEMA — and the entire federal government — in the coming months.”

    Learn more

    Be prepared for disruption

    Speaking during her session at the 2021 Medical Practice Excellence: Pathways Conference, Taya Moheiser, MBA, CMPE, CMOM, owner, ITS Healthcare LLC, cautioned that 2021 should not be treated as an opportunity to let your guard down as a medical practice leader. Instead, it’s a perfect time to re-engineer processes to be less reactive and more innovative when it comes to business continuity strategies for future “what-if” scenarios.

    “Look back at 2020 and all the steps you took,” Moheiser added. “Do you have all those documented? You should … because you can improve upon what you did last year.”

    Preparing for every scenario

    Lessons learned during the COVID-19 pandemic should be reviewed as healthcare leaders reevaluate business continuity and disaster recovery (BCDR) plans. “Preparedness for many was the difference in 2020 between thriving and supporting your community or shutting your doors,” Moheiser said.

    For some practices, these plans may have focused heavily on protecting against data loss, but a robust BCDR plan examines multiple areas to ensure no loss of continuity in operations and workflow in a large-scale disaster, Moheiser added. The critical functions beyond servers, computers, patient records and backups would include alternative locations for business operations, documentation for revenue continuity and ongoing risk management during a disaster.

    A strong communication strategy unifies these elements internally, Moheiser noted, as well as with external partners such as your vendors. “Don’t be shy about reaching out to vendors for what other services they offer [and] identify how long it would take you to implement those things,” Moheiser urged. “Because when an emergency hits, all their clients … are filling their inboxes and their voicemail. Get ahead of that by already having the information at your fingertips.”

    With that information, you can begin to think creatively about what your technology and staff are capable of in various scenarios and then codify steps for each one. It’s also important for practice leaders to consider the potential needs from new vendors in the event of an emergency that displaces staff; remote workstation and digital phone capabilities may not be a day-to-day need but assessing vendors in times of relative calm can help build out a plan for implementation when a rapid launch is needed in times of crisis. A BCDR plan should document vendor contacts, as well as which individual from your organization is responsible for reaching out.

    But a BCDR is only as good as its ability to be understood and implemented by your organization. Even if your practice has a robust BCDR, “transparency is key” and simulations of certain scenarios can be effective ways to help your staff know what to do and reduce worry in a real disaster, Moheiser added. “When the first thought is, ‘I practiced for this,’ it’s a lot more comforting.”

    Key contacts

    Your list of key contacts should include:

    • Incident managers
    • Owners
    • Employees and emergency contacts
    • Property managers
    • Insurance coverage companies
    • Patients.

    Consider phone trees, notification lists, automated services and pre-set notification groups in your phone or email that are accessible regardless of location. Keep in mind that digital patient data must always be stored in an encrypted and secure way.

    Compliance considerations

    While the COVID-19 pandemic ushered in numerous waivers of certain regulations around the HIPAA rule and the ability to offer telehealth services that were previously limited, Moheiser cautions that “HIPAA never disappeared,” and it remains crucial for practices to pay attention to requirements around protecting health information.

    “In the event that you have to go outside of the standard HIPAA rule during an emergency, you must be prepared to show that there was solid cause, that it was patient safety related, and that you made every good faith effort to protect the patient’s information and to stay in alignment with HIPAA,” Moheiser said. In addition to electronic safeguards, she cautioned on the need to ensure physical safeguards on locations where data is stored. “When we all reverted to home [during the pandemic] and everybody went digital, many of us locked the doors of our practices and were away for weeks,” Moheiser said, and someone on the incident management team needs to keep track of facilities.

    Especially in incidents in which worker safety might be affected, the appropriate OSHA regulations should be noted in a BCDR plan for quick reference, as well as any state laws around emergency powers or Good Samaritan laws. It can be as simple as including a hyperlink to the most up-to-date information from trusted sources rather than searching for it amid an emergency.

    From reactive to innovative

    For a forward-thinking practice manager, the phrase, “if it ain’t broke, don’t fix it,” no longer applies in building out plans that prepare the organization for the unexpected, Moheiser said. It’s important to entertain “what-if” scenarios that can be planned for before an emergency happens.

    Optimizing communication strategies often hold the key to responding appropriately and effectively in these scenarios:

    • Using appointment confirmation technologies to issue mass notifications is an easy way to get messages out via text, email or phone.
    • Platforms that allow you to separate staff, owners and other individuals into different “buckets” for role-specific communications are even more important to deliver tailored messaging to different groups.
    • Social media platforms are another useful messaging tool, but always be mindful not to share any patient information.
    • Regardless of the platform or tool, document who is accountable for disseminating these communications and consider scripting sample messages for different scenarios.
    • If your staff don’t already have adequate computers and internet connections for working remotely, identify those who have mobile hotspots or other technology to enable them to respond regardless of location in an emergency.
    • As with any technology, test it before it’s needed in an emergency so it can be used in time-sensitive situations. 

    Navigating the pandemic heading into 2022

    Kem Tolliver, CMPE, CPC, CMOM, president and chief executive officer, Medical Revenue Cycle Specialists, said that while Moheiser’s advice around BCDR plans can apply to any scenario, there are several ways to use these approaches to continue working through the response to the COVID-19 pandemic.

    As updates to a BCDR plan are made, reevaluate your staffing gaps and your staff members’ job descriptions to update accordingly. Spelling out specific duties in various scenarios will provide guidance on which employees will be responsible for various duties in BCDR-defined situations.

    In some cases, it might make sense to update or create new job titles. In the case of medical assistants who have shifted specifically toward becoming telehealth liaisons or coordinators, it might help clarify to internal team members and patients who they should turn to for specific concerns, Tolliver said.

    If employees need to take on new responsibilities, make sure you’re auditing employee files for certification requirements at least annually. “Determine whether there’s anything that’s missing from your employee’s toolbox in order for them to effectively do their jobs,” Tolliver suggested.

    These updates help bring certainty to team members’ understanding of their roles and can help them instead focus on achieving better patient engagements that can discourage no-shows or care avoidance.

    Do you have any best practices or success stories to share on this topic? Please let us know by emailing us at

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