Hurricane Harvey’s Created a Public Health Catastrophe

by Phil C. Solomon on September 6, 2017

in Revenue Cycle Management

Hurricane Harvey wreaked havoc in southeastern Texas last week and created a public health crisis.  The tropical cyclone or what is called a category four hurricane caused unprecedented and catastrophic flooding in the southeastern part of the state.  It was the first major hurricane in the U.S. since Wilma in 2005, a category five hurricane with winds of up to 185 mph.

Harvey is the wettest storm on record in the contiguous United States and is “almost certain” to be at least the third worst storm in U.S. history when it comes to damage costs, according to Enki Research.  The firm’s current estimate ranges from $48 billion to $75 billion, with an average of $57 billion.  However, those numbers are subject to change with each passing day.  “The computer models we normally use to do estimates for hurricanes don’t work that well for this kind of a storm,” Chuck Watson, the director of research and development at Enki Research, said.

The resulting floods inundated hundreds of thousands of homes, displaced more than 30,000 people and prompted over 13,000 rescues.  Medical services and hospitals were taxed beyond capability, especially since many hospitals and medical facilities were closed and evacuated.

Though Hurricane Harvey pounded Texas with a national rainfall record for a tropical storm, crisis management coordination between the state and Texas hospitals ensured care was minimally interrupted.  The South East Texas Regional Advisory Council (SETRAC) claims that roughly 90 percent of healthcare facilities will return to full service by October, according to STAT News.

The outcome could have been much worse, considering the nature of the storm.  Houstonians pulled together and weathered the storm with great determination.  Addressing Harvey’s effects required a resourcefulness that no other catastrophe has necessitated.  The storm has challenged a comprehensive disaster plan the city and surrounding counties had prepared.  The devastation so far has been unimaginable.

The host of National Public Radio’s (NPR) show, All Things Considered, Kelly McEvers spoke with Darrell Pile, CEO of SETRAC which runs the catastrophic medical operations center which will offer a perspective of the medical challenges experienced during the storm.  This interview has been edited for length and clarity.

NPR Interview Highlights

While the storm has largely left Houston, the flooding continues.  What is the situation with the hospitals you are working with?

The flooding is devastating, and we have at least two reservoirs where water is having to be released and is, in fact, flooding neighborhoods as we speak and has placed three hospitals in harm’s way.

The three hospitals are monitoring the water coming from the two reservoirs very closely, and they could, depending on the flow of the water, find that they could become inaccessible to EMS agencies.  We are tracking that very closely.

The situation with residents in their homes—some are on the second floor of their homes—the evacuation process [for those neighborhoods] continues, and, as a result, it is unclear what the demands on the health care system may be.  However, most hospitals are up and fully functional, and we believe we can handle any new demands that happen today or tomorrow.

Has the catastrophic medical operations center ever handled anything like this?

No.  The phone lines at one point became inundated.  The amount of resources needed began to exceed what we had available.  The calls included patients needing dialysis who might be at home.  It included hospitals saying we need to evacuate.  One call was asking for 50 wheelchairs to be sent to a shelter.  We did not have 50 wheelchairs left.  Fortunately, our governor declared a disaster and the president declared a disaster and resources have been brought in from all over the state and all over the nation to help us.

How did you get those 50 wheelchairs?

I am not clear on how they ended up getting the 50 wheelchairs, but I can tell you, it can be accomplished just through one or two tweets to Houstonians.  Those with wheelchairs perhaps in their attic or stored [elsewhere] could bring an abundance of wheelchairs, perhaps more than you even need.  So there are methods to solve every problem.  It is just having enough people to make the calls or to be innovative and creative to solve the problems.  This community has come to the call.

A number of hospitals did evacuate, either prior to the storm or during. How difficult is it to evacuate a hospital?

It’s not as simple as pulling up a bus or a convoy of ambulances and moving patients from one hospital to another hospital.  My organization makes sure that the receiving hospital meets the need of every single patient they agree to receive.  As a result, the evacuation of a hospital might mean we must identify ten different hospitals to meet the unique needs of each patient.

Every day, three times per day, we have hospitals electronically advise us of beds that they have available and the type.  So a pediatric patient goes to a pediatric bed.

Moreover, we have also spent time making sure the receiving hospital is not in harm’s way so that the patient would not have to be evacuated twice.  We have worked with the [Texas] Department of State Health Services to also identify hospitals with beds available in cities such as Dallas or San Antonio or Austin or even further away so that a patient doesn’t move twice.

Some Houston hospitals added flood protections as a result of other devastating storms, including Allison in 2001. Have those worked?

Absolutely.  We had a situation where in prior storms, water came into a tunnel system that connects the Texas Medical Center hospitals.  [The tunnels] make it easier to go from one hospital to another hospital.  However, waters came in and flooded every hospital through that tunnel system.

The Texas Medical Center invested in submarine-type doorways, and when there is a risk of flooding, they now close those doorways.  So each hospital is compartmentalized.  As a result, this storm—even though flooding devastated our community, it did not devastate Texas Medical Center.  So, congratulations to the Texas Medical Center.

Do the hospitals have the staff they need right now?

I can imagine some of the hospitals have fewer employees available to staff the hospital.  Some members of their workforce have lost everything—their homes destroyed, their automobiles destroyed.

Tomorrow, we will be holding a meeting to discuss what our hospitals need.  And from there we will be identifying where we need to place nurses.  We have an abundance of nurses from throughout Texas who have offered to help.  We also have an abundance of physicians who have offered to help.  Now it’s a matter of making sure we place them in the proper facilities.

The Aftermath of Hurricane Harvey

Hurricane Harvey began with raging winds, but its legacy will be the seemingly endless stream of water that swamped parts of Houston and the surrounding area.  Harvey whipped up tons of water from the sea and hurled it down on the country’s fourth most populous city, drowning vast tracks of the landscape and battering it with almost a year’s worth of rainfall in less than a week.

Houstonians are strong and will rebound from Harvey’s devastation.  So will its hospitals and medical community.  The rebuilding process will not happen without the assistance of those within and outside the healthcare industry.  The American Hospital Association (AHA) has been supporting colleagues at the Texas Hospital Association as they work with hospitals and health systems, as well as local and federal agencies, to respond to the ongoing disaster.

Concerned citizens can help relief efforts in a number of ways:

Blood Donations: The American Association of Blood Banks (AABB) is urging eligible donors, especially those with type O-positive blood, to make donation appointments as soon as possible.  Those interested in donating may contact the following organizations to find a local blood drive and schedule an appointment:

Texas Hospital Association Assistance Fund: The Texas Hospital Association has established an assistance fund to help hospital employees who experienced significant property loss or damage.  Administrative services are being provided in kind, so 100 percent of donations can be used to assist individuals in need. AHA has contributed an initial $50,000 to get the fund started.

For more information or to make a donation, visit https://www.tha.org/Harvey/ReliefFund.  For additional details, visit www.tha.org/harvey.

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Phil C. Solomon is the publisher of Revenue Cycle News, a healthcare business information blog and serves as the Vice President of Marketing Strategy for MiraMed, a healthcare revenue cycle outsourcing company.  As an executive leader, he is responsible for creating and executing sales and marketing strategies which drive new business development and client engagement. Phil has over 25 years’ experience consulting on a broad range of healthcare initiatives for clinical and revenue cycle performance improvement.  He has worked with industry’s largest health systems developing executable strategies for revenue enhancement, expense reduction, and clinical transformation. He can be reached at philcsolomon@gmail.com

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