Disaster Planning for Your Practice

If there's one thing you can count on in a medical practice, it's the unexpected. From flu pandemics to vaccine recalls to weather-related disasters, each new season brings with it a new crop of potential challenges. Ben McKown can attest to this.

As a long-time administrator of orthopedic practices in New Orleans, McKown experienced firsthand the chaos wrought by Hurricane Katrina in 2005. "The practice I was working with at the time was caught totally off guard," he recalls.

The 9-physician practice he works with now, Southern Orthopedic Specialists, is better prepared - having drafted an extensive disaster plan that will help restore operations faster should Mother Nature strike again. "We all got the message after Katrina," says McKown. "You have to ask yourself 'What if everything goes wrong? What would you do if you had to leave the office today?'"

Disasters, of course, come in all shapes and sizes. "It's not just the events that get 24-hour news coverage," says Owen Dahl, a practice management consultant in Houston, Texas, and author of "The Medical Practice Disaster Planning Workbook." "It can be a singular event that affects just your office like a fire or flood." Perhaps someone in the parking lot hits the accelerator instead of the brakes and crashes into your building. Or maybe 80 percent of your staff calls in sick during flu season.

Secure your data

The first step to creating a disaster and recovery plan, says Dahl, is to secure your data - including your billing, electronic health record, and accounting systems. Without information, you don't have a practice. "All of your electronic information needs to be backed up," says Dahl. "That doesn't mean back it up and leave the discs or tapes in your office. You have to store them securely offsite."

If you still use paper charts, implement the "three lock" rule. "That's kind of an old way of doing it where you store your records in a room that has some form of barrier (like a fire wall), ideally behind three locked doors within your office," says John M. Emerson, a healthcare business consultant and interim practice administrator (CEO) for Michigan Multispecialty Physicians in Ann Arbor, Mich. "The storage units you use to hold the records should also be rated for fire, smoke, and water resistance."

Next, secure your physical assets, including your building structure, computers, and medical equipment, says McKown. If the threat involves severe weather cover your electronic equipment with plastic sheets, unplug your computers and diagnostic equipment, and designate someone to handle building security, ensuring the office is vacant, lights are out, and doors are locked.

"Break the tasks down into individual assignments and assign people to handle those things ahead of time," says McKown, who encourages practices to execute drills once a year. "We had a hurricane that was brewing off the Gulf of Mexico a few weeks ago that turned out to be nothing, but we used it as a dry run for a full blast hurricane and ran through the checklist. We later looked back to evaluate what we missed."

Communication

During any type of emergency you must also be able to communicate with your staff. "Create an employee portal on your Web site for updates," says Dahl, or establish a telephone hotline with recorded information. Smaller practices can use a phone tree -designating a few responsible employees to call those on their team.

Be sure to provide specific guidance to your staff about what they're expected to do and when they're expected to do it. "If there's been a forced evacuation of the city, for example, the standing orders would be that all employees are expected to be back at their job 24 hours after the evacuation has lifted," says McKown. "That eliminates a lot of extra phone calls."

You must also, of course, communicate with your patients. Post an alert banner on your Web site with updates, letting patients know how long your practice will be closed, how to reach their physician in case of an emergency, and, if relevant, where doctors will be treating patients temporarily until the office reopens. Create a list with all your patient's e-mail addresses and send out e-mails with regular updates. And leave a recorded message on your office answering machine.

If you're in a vulnerable area, like the northeast where blizzards frequently shut down roads or coastal towns that get evacuated for hurricanes, you might consider giving those patients who require daily or weekly office visits a hard copy of their medical record so they can obtain the care they need elsewhere while you're closed.

Grab and go

It's also wise to create a grab-and-go emergency kit that contains critical contact information and basic supplies that would enable you to run an office from a temporary location - say, a spare room at another practice. "You should include in there insurance forms and lab request forms, medical reference books, patient lists, prescription pads, blood pressure cuffs, thermometers, wound care supplies, stethoscopes, phone chargers, basic medications - the things you'd need to function as a mobile auxiliary surgical hospital unit if necessary," says Emerson.

For his part, McKown says he provides every employee in his practice with a disaster plan book that includes a list of key phone numbers, including contact information for staff members, insurance payers, and vendors - electricians, plumbers, information technology providers, and banking representatives. He also makes direct deposit mandatory for his employees, thus enabling the practice to continue making payroll regardless of any interruption. And he arranges automatic deposit with as many insurance payers as possible to help maintain cash flow during times of business interruption. His banking and answering service vendors are based outside the New Orleans area for added security.

Insurance

Lastly, when prepping for disaster, it's important to confirm that your practice's insurance coverage is up to date - before you need to file a claim. "Find out what kind of coverage you have," says Dahl. "If your building is in a fire and you're not in operation for two weeks, is there a waiting period before your coverage kicks in - like after the first three days? What are the legitimate reasons that trigger the event of a business interruption? You want to have all that in place."

There's no way to prevent disasters, of course, but you can minimize disruption by doing some basic preemptive planning. "I would advise anybody, anywhere, to have a plan for their practice," says McKown. "Look at the folks [in New York City] after the attacks of 9/11. They didn't expect that either."

Shelly K. Schwartz, a freelance writer in Maplewood, N.J., has covered personal finance, technology, and healthcare for more than 12 years. Her work has appeared on CNNMoney.com, Bankrate.com, and Health Family magazine. She can be reached via editor@physicianspractice.com.

This article originally appeared in the November 2010 issue of Physicians Practice.