Published on October 3, 2007
Dodging Disaster: Planning Ahead for the Unexpected: Dodging Disaster: Planning Ahead for the Unexpected Marsha K. Millonig, MBA, RPh President Catalyst Enterprises, LCC ASAP Annual Industry & Technology Issues Conference January 26-28, 2006 St. Pete Beach, FL Why Care?: Why Care? Slide3: We are getting warmer… Warming results in…: Warming results in… Rises in sea level Changes in the amount and pattern of precipitation Increases extreme weather events: Floods Droughts heat waves Hurricanes… Contributing to biological extinctions… Slide6: Cyclone Catarina, a rare South Atlantic tropical cyclone viewed from the International Space Station on March 26, 2004. Slide7: Hurricane Katrina… Slide8: http://en.wikipedia.org/wiki/Hurricane_katrina Slide9: A cargo ship pushed ashore by the force of Hurricane Katrina sits amid the devastation in the southern part of Plaquemines Parish, La., site of the storm’s Louisiana landfall. JAPhA 45. 6. 654-658. SOURCE: NATIONAL OCEANIC & ATMOSPHERIC ADMINISTRATION. Slide10: This part of Slidell, La., across Lake Pontchartrain from New Orleans, was leveled by the Category 4 winds of Hurricane Katrina. JAPhA 45. 6. 654-658. SOURCE: FEDERAL EMERGENCY MANAGEMENT AGENCY/LIZ ROLL. Slide11: A tornado in Union City, Oklahoma in 1973. http://en.wikipedia.org/wiki/Tornado Slide13: Hurricane Ivan… How much notice? What would you do? Walking away…what would you take? : How much notice? What would you do? Walking away…what would you take? Be prepared…: Be prepared… …both personally and professionally. Today’s Objectives: Today’s Objectives Describe approaches to “personal and family disaster” planning; Describe steps involved with business-related disaster planning; Name resources to assist with disaster planning; Understand technology-related disaster planning requirements in HIPAA; and, List several off-site disaster recovery related resources Personal & Family Planning: Personal & Family Planning Be prepared for up to 72 hours Make a disaster plan Family communications plan Evacuation plan Disaster supplies kit Family Communications Plan: Family Communications Plan Discuss the types of disasters that are most likely to happen. Explain what to do in each case. Pick two places to meet: 1. Right outside your home in case of a sudden emergency, like a fire. 2. Outside your neighborhood in case you can’t return home. Everyone must know the address and phone number. Family Communications Plan: Family Communications Plan Ask an out-of-state friend to be your “family contact.” After a disaster, it’s often easier to call long distance. Other family members should call this person and tell them where they are. Everyone must know your contact’s phone number. Discuss what to do in an evacuation. Plan how to take care of your pets. Write down all of these contact numbers and information on the family emergency contact card at http://www.redcross.org/prepare/ECCard.pdf Evacuation Plan: Evacuation Plan Local government officials issue evacuation orders Listen to local radio and television reports If local officials ask you to leave, do so immediately Evacuation Plan: Evacuation Plan Wear long-sleeved shirts, long pants and sturdy shoes so you can be protected as much as possible. Take your disaster supplies kit. Take your pets with you; do not leave them behind. Because pets are not permitted in public shelters, follow your plan to go to a relative's or friend's home, or find a "pet-friendly" hotel. Lock your home. Use travel routes specified by local authorities — don't use shortcuts because certain areas may be impassable or dangerous. Stay away from downed power lines. Grab and Go:: Grab and Go: Medical supplies: prescription medications and dentures. Disaster supplies: flashlight, batteries, radio, first aid kit, bottled water Clothing and bedding: a change of clothes and a sleeping bag or bedroll and pillow for each household member Car keys and keys to the place you may be going (friend's or relative's home) Complete Checklist: Complete Checklist Post emergency telephone numbers by phones (fire, police, ambulance, etc.). Teach children how and when to call 911 or your local Emergency Medical Services number for emergency help. Show each family member how and when to turn off the water, gas and electricity at the main switches. Check if you have adequate insurance coverage. Teach each family member how to use the fire extinguisher (ABC type), and show them where it’s kept. Complete Checklist: Complete Checklist Install smoke detectors on each level of your home, especially near bedrooms. Conduct a home hazard hunt. Stock emergency supplies and assemble a Disaster Supplies Kit: water, food, first aid supplies, clothing and bedding, tools and emergency supplies, and special items for medical conditions. Take a Red Cross first aid and CPR class. Determine the best escape routes from your home. Find two ways out of each room. Find the safe spots in your home for each type of disaster. Important Papers to Take: Important Papers to Take Driver's license or personal identification Social Security card Proof of residence (deed or lease) Insurance policies Birth and marriage certificates Stocks, bonds, and other negotiable certificates Wills, deeds, and copies of recent tax returns NYT: Money Column : NYT: Money Column How to Prepare for a Quick Getaway Recommends digital photos, scanning documents and word documents stored on flash disks Credit cards, bank accounts, investment accounts, insurance policies, SSN and their related toll-free numbers and passwords List of where important papers are stored Hurricane Katrina: Hurricane Katrina One of the most difficult issues was access to medical records and medication histories Bush cabinet meeting after 1st post-Katrina Visit tasking each cabinet member to create response plan Leavitt at dHHS calls upon Brailer to form Task Force Task Force: Med. Histories: Task Force: Med. Histories Markle Foundation facilitates Brings together numerous parties, including RxHub, SureScripts and Gold Standard RxHub provides payer history files for 2-3 million affected individuals SureScripts provides patient history across several retailers in area Gold Standard brings Medicaid data and serves as the tech vendor Task Force: Med Histories: Task Force: Med Histories Within 10 days, all data was brought together for credentialed (through AMA) access at Katrina shelters and at katrinahealth.org Led to follow up questions: what should we be doing beyond medication histories? In the future: EMRs and Practice Management Systems=diagnosis and labs HL7 Effort: HL7 Effort The HL7 Response and Recovery Taskforce Portable Records Plan 1.0 Draft 4, Oct. 6, 2005 Standards-based framework for application and service providers to deploy “on the ground” solutions for portable electronic records Requirements: Requirements 1. Fast on-site deployment with minimal set-up or training. 2. Electronic records can be retrieved at point of care, and are readable with minimal local support (Internet connection, web browser). 3. Records can be queried by patient name and / or identifier; additional query parameters desirable: document type, date, practice setting. 4. Management, access, and retrieval not tied to specific type of document creation technology. 5. Clinical documents generated during an encounter can be correlated with diagnostic reports and medication history according to patient name, identifier, and date within the same repository Business Disaster Planning: Business Disaster Planning Part of the HIPAA security requirements Standard Seven Requires the covered entity to establish and implement as needed policies and procedures for responding to an emergency or other occurrence (i.e., fire, theft, natural disaster) that damages systems containing electronic PHI Five implementation specifications Contingency plans must be documented and kept for 6 years HIPAA Security Requirements: HIPAA Security Requirements Data backup plan (Required): You must have procedures to create and maintain retrievable exact copies of electronic PHI. Disaster recovery plan (Required): You must have procedures to restore any loss of data. Emergency mode operation plan (Required): You must have procedures that allow critical business processes for protection of the security of electronic PHI to continue while the entity operates in emergency mode. HIPAA Security Requirements: HIPAA Security Requirements Testing and revision procedures (Addressable): You must have procedures to periodically test and revise your contingency plans. • Application and data criticality analysis (Addressable): You must assess the relative criticality of specific applications and data in support of other contingency plan components. Business Disaster Planning: Business Disaster Planning Establish planning team Analyze capabilities and hazards Conduct vulnerability analysis Develop and implement the plan Download Emergency Management Guide for Business and Industry at: http://www.fema.gov/library//bizindex.shtm Some considerations…think about…: Some considerations…think about… …how a disaster could affect your employees, customers and workplace. …how you could continue doing business if the area around your facility is closed or streets are impassable. …what you would need to serve your customers even if your facility is closed. Consider as part of the plan:: Consider as part of the plan: Make a matrix, with these three as the columns, and each of your activities as a row. (Beyond the obvious, your activities include things like "accounts receivable," "payroll," "real estate management," etc., depending on your situation.) Then figure out how you would respond to loss of information, access, and/or personnel for each function. Appoint a second in command. If the person normally in charge is injured in the disaster or not available, the second in command should be named in the plan, and delegated full authority in this situation. If you can't name someone, you have already pinpointed one of your greatest vulnerabilities! Consider as part of plan:: Consider as part of plan: Keep phone lists of your key employees and customers with you, and provide copies to key staff members. If you have a voice mail system at your office, designate one remote number on which you can record messages for employees. Provide the number to all employees. Arrange for programmable call forwarding for your main business line(s). Then, if you can't get to the office, you can call in and reprogram the phones to ring elsewhere. If you may not be able to get to your office quickly after an emergency, leave keys and alarm code(s) with a trusted employee or friend who is closer. Consider as part of plan:: Consider as part of plan: Install emergency lights that turn on when the power goes out. They are inexpensive and widely available at building supply retailers. Back up computer data frequently throughout the business day. Keep a backup tape off site. Use UL-listed surge protectors and battery backup systems. They will add protection for sensitive equipment and help prevent a computer crash if the power goes out. Purchase a NOAA Weather Radio with a tone alert feature. Keep it on and when the signal sounds, listen for information about severe weather and protective actions to take. Consider as part of plan:: Consider as part of plan: Stock a minimum supply of the goods, materials and equipment you would need for business continuity. Consult with your insurance agent about precautions to take for disasters that may directly impact your business. Remember, most policies do not cover earthquake and flood damage. Protect valuable property and equipment with special riders. Discuss business continuity insurance with your agent. Keep emergency supplies handy, including- Flashlights with extra batteries. First aid kit. Tools. Food and water for employees and customers to use during a period of unexpected confinement at your business, such as if a tanker truck over-turned nearby and authorities told everyone in the area to stay put for an extended period. Consider as part of the plan:: Consider as part of the plan: List individual responsibilities ahead of time, and assign specific people to each task. This includes tasks such as notifying your suppliers where to deliver, calling your most important customers to tell them what has happened, calling your Board members, etc. Protect critical paper records. Even in a fully automated organization, there can be vulnerable records - such as "pending" contracts, advertising, research, loan applications, etc. - which only exist on paper. Set clear priorities among your activities. After a disaster, you will not return everything to normal at the same time. Decide beforehand the longest amount of time you are willing to be "dead in the water" for each of your activities. Consider as part of the plan:: Consider as part of the plan: Have a backup connection to your main computer. Make sure that your main computer (either at your service bureau, your main office, or your hotsite) can "dial out" in the event that your leased-lines are lost, or in the event that you must relocate to a different site. Make sure that employees can exit without a key. This may sound obvious, but in many organizatons, once the doors are locked at the end of the day to keep the customers out, employees staying late to process work are locked in. Keep copies of all of your forms off site. This includes extra checks so that you can buy the emergency supplies you need. Keep a copy of your disaster plan at home. Make sure it includes the home phone numbers of the service people you rely on: your insurance agent, plumber, electrician, etc. Many Good Resources: Many Good Resources American Red Cross: www.redcross.org FEMA: www.fema.gov Institute for Business and Home Safety: http://www.ibhs.org/business_protection/ www.about: www.about http://management.about.com/od/disasterplanning/ Articles and links: Keeping BCP High on the Corporate Priority List & The BCP Handbook Disaster Recovery Planning Process Network Disaster Recovery Data Backup Is The Best Data Protection Who'll Stop the Rain? Preparing Your Business For the Unthinkable Preparing the Disaster Recovery Plan Many Good Resources: Many Good Resources HIPAA Security Requirements ASAP Meetings and Resources Computer Talk Buyer’s Guide Data Warehousing and Recovery Services: Data Warehousing and Recovery Services A number of types Redundant systems Alternate sites Real time vs. back up Automatic roll over to servers Continuous monitoring Nightly back ups with data replication to third party Computer Talk Buyers Guide: Computer Talk Buyers Guide Computer Talk Buyers Guide: Computer Talk Buyers Guide Freedom Data Services EZ Data Warehouse is a real time repository of pharmacy prescription data collected via a secure Internet connection. Powerful query based reporting tools mine data to analyze margins, costs, over-the-counter (OTC) performance, prescription trends, and inventory control. Computer Talk Buyers Guide: Computer Talk Buyers Guide Health Business Systems Recommend a frame-relay (or the like) network to connect pharmacies to the host With network reinforced by dial back-up services that can, on-demand, provide access to the host, should the primary network fail Nightly full system backup to local tape device with ability to replicate the data to a secondary server Offsite data replication to a third party vendor is available Computer Talk Buyers Guide: Computer Talk Buyers Guide SXC Maintain primary and alternate data centers with monthly testing Redundant computer systems for claims processing, prescription processing and web-based services Off-site storage of daily system backups Computer Talk Buyers Guide: Computer Talk Buyers Guide Two Point Conversion, Inc. Archiving services CD-Rom technology Extra records kept off-site Software to query archived data Thanks for Having Me!: Thanks for Having Me! www.catalystenterprises.net email@example.com Tel: 651-905-9002 Fax: 651-905-9004
Dodging Disaster: Planning Ahead for the Unexpected Dodging Disaster: Planning Ahead for the Unexpected . Marsha K. Millonig, MBA, RPh
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