Unfortunately, natural and man-made disasters are events that Americans have become accustomed to seeing in the news. From wildfires in the West to hurricanes in the East, these catastrophes are staple topics in the news cycle. These events trigger critical questions. What does medical care look like during these events of almost complete devastation? How prepared is our healthcare system? How can health information technology (IT) support disaster response?
Lauren Knieser, Senior Director at Audacious Inquiry, A PointClickCare Company, recently sat down with HIT Like a Girl Podcast co-host, Joy Rios, to discuss tangible ways Audacious Inquiry’s technology is supporting individuals on the ground during these disasters. She also shared valuable lessons learned from her career in public health and how that knowledge informs her work in health IT.
Discovering a Passion for Public Health
Knieser’s interest in public health started at an early age with dreams of becoming a doctor. Along the journey, she realized that a career as a doctor was no longer the path she wanted to pursue. Instead, she volunteered for AmeriCorps where she discovered her true passion was for public health. While getting her master’s degree in epidemiology and doctorate in environmental health, Knieser went on to build a career in various aspects of state and federal public health programs with an emphasis on disaster preparedness and response research, policy, and education. She brought this rich experience in disaster response to Audacious Inquiry in January of 2020, when she joined as a Senior Director to focus on how health information technology could better support health care delivery during disasters and public health emergencies. Little did she know, mere weeks into her tenure, the COVID-19 pandemic would accelerate efforts in this space.
Her background and experience provide first-hand insight into the urgent need for patient data access and continuing patient care services after a disaster.
How Health IT for Disaster Response Supports Continuity of Care
Knieser mentioned during the interview that disasters range in scope, intensity, and duration from something like a bus accident that is a local issue to a hurricane that is regional, all the way up to a global pandemic. Regardless of scale, Knieser’s definition is, “Any disruption that overwhelms the routine healthcare infrastructure has the potential to be a disaster.” These events usually require emergency response support. Disaster preparedness ensures that health IT systems are ready to support a wide range of patients, clinicians, and scenarios who find themselves displaced from their routine care setting or dealing with a healthcare infrastructure that is overwhelmed by an emergent situation.
There are many ways that health information technology is crucial when patients and/or their clinicians are facing the fallout from an emergency or natural disaster. Audacious Inquiry’s technology solutions support continuity of care, care coordination, secure data exchange, and resource tracking during disasters in three principal ways:
- Care coordination technology, such as real-time admission, discharge, transfer (ADT) alerts, support continuity of care for patients who receive health care outside of their routine care environments. Alerts give physicians or other relevant healthcare providers notifications when their patient has been seen at a healthcare facility outside of the patient’s usual radius of care.
- The exchange of documents allows patient clinical and medication histories to augment the information contained in ADT alerts. For example, emergency care workers in shelters can search for a patient and review medical history to support informed clinical decision-making, treatments, and referrals.
- When individuals are displaced, reunification specialists and care coordinators can identify whether missing family members or unaccounted for patients have shown up in a hospital, emergency department, or shelter participating in the health IT network.
Audacious Inquiry also ensures continuity of care by encouraging partners to have an emergency and communication plan in place should a disaster arise.
The Future of Disaster Preparedness
In 2018, CMS issued a rule requiring hospitals and other health care facilities to have an emergency plan, a communications plan, implement policies and procedures, and lead training and testing efforts for disaster response. The Emergency Preparedness Rule set the tone for expectations of health care in disaster response.
In light of the challenges experienced during the COVID-19 pandemic, CMS recently proposed a new rule requiring hospitals to share capacity data through the duration of the pandemic and for future public health emergencies. Feedback for this rule was due on June 17, 2022.
This proposed rule represents another significant regulatory step towards establishing expectations of health care during disaster response. It augments the Emergency Preparedness Rule by directly addressing gaps in local, state, and federal ability to support health care facilities during disasters and public health emergencies due to limited visibility on current patient load, patient acuity, and resourcing. During the COVID-19 response, hospitals and long-term care facilities were required to report situational awareness data to state and federal governments; however, there was no established standard by which to share this information, which resulted in confusion and logistical challenges. This proposed rule is an effort to improve data sharing by establishing a reporting requirement in advance, before disaster strikes, incentivizing healthcare providers and suppliers to be prepared for a worst-case scenario.
Reliable data exchange plays an indispensable role not only in disaster scenarios, but also in a patient’s day-to-day care. Access to transparent data is imperative to preventing gaps in care coordination and to ensuring patients receive high-quality care from providers as they move through the care continuum.
At Audacious Inquiry, we make sure that no matter the setting, patient care remains top priority. Thanks to our talented team of experts like Lauren Knieser, our systems are continually improving and becoming better prepared to handle crisis situations.
Listen to Lauren’s podcast interview on HIT Like a Girl Podcast here. And to learn more about how Audacious Inquiry, A PointClickCare Company supports care during disasters, download our Disaster and Emergency Preparedness Guide below.
About Lauren Knieser
Lauren (Walsh) Knieser has 15 years of experience in preparedness, response and recovery work and is passionate about solving complex challenges related to supporting individuals, families, and communities who have been affected by disasters and public health emergencies. In January of 2020, she joined Audacious Inquiry, a PointClickCare company, to lead their Emergency Preparedness and Response portfolio. Her current work builds off national advancements in health IT to apply modern care coordination technologies to disaster settings.
Lauren joined Audacious after eight years in federal service where she supported policy, research, and operational response. Prior to that, she held positions with the American Medical Association’s Center for Disaster Medicine and Public Health Preparedness and Columbia University’s National Center for Disaster Preparedness. She holds a DrPH in Environmental Health and Engineering from Johns Hopkins University and a MPH in Epidemiology from Columbia University.