| EQRS Feature Updates/Discussion | HCD Team/EDIs | Emergency Preparedness/Response Module in EQRS Discussion - Today's meeting is to give the EDI's the opportunity to share with the group what is their process during an emergency (COVID, hurricane, fire)
- What are your pain points?
- What improvements would you like to see?
- What is the process the EDIs follow for hurricanes?
- FKC
- Per Michael Blaney - first monitors all the activity in the Atlantic Pacific and Central Pacific for any potential tropical or hurricane storms that are named
- Provides an overview of each storm direction, where it is going; percentage of development; shared with about 50-75 people within FKC
- If the storm looks like it will hit landfall, the information is shared to local management and technical teams about 5 days out from the storm making landfall
- Allows them to make local laboratory calls
- Initiates calls to the RVPs, DOs and CMs and technical folks so they can put responsive plans in place on what they need to do
- Each day Michael Blaney provides an update to those folks mentioned above
- 2-3 days out Michael Blaney, Bob Loeper, Scott Riddell and other folks of the incident command team are invited to participate in the local calls
- If a hurricane is imminent about 3 days out, the incident command team holds their own individual call
- Within FKC they have about 7 incident command teams each made up of about 5-7 folks
- The incident team determines what might be the appropriate staging area
- FKC has a tracker tool that is used to identify the facility status (early closing, land closing, early opening shift changes, etc
- Once the storm hits, FKC gets an open/closed status; if on city or municipal power, if on generator power or no power at all; do they have water; is water supply needed
- Then work with local management to determine a place to set up; typically, in a parking lot of the facility; then supplies are brought in
- The regional administrative assistant works with the RVP to update the disaster tracker tool daily
- A group in FKC pulls the information out of the disaster tracker tool and populates it into an excel spreadsheet called the ESSR
- The ESSR is then provided to the senior management within that region and impact zone RVPs. Michael, Scott and Bob; then the ESSR report is shared with KCER for their utilization and distribution and daily calls
- This information is sent as an attachment in an email
- Per Michael, they also maintain all the emergency contact information for each of the patients
- Right before the storm hits, they print and distribute a transitional summary report to each of the patients (identifies the meds they are on and prescriptions for dialysis
- An emergency number is also given to each patient to call for dialysis centers they may go to with close proximity to where they are for dialysis treatment
- They emphasize with the patients to make sure they answer their phones during an emergency; the home-based facility may be closed down so calls may come from clinical manager's, social worker's personal home or cell phone numbers
- They also work with their IT team; once they start accounting for their patients, the IT team can send a text message out to the patient to verify if the patient is ok
- Another method of contacting/locating the patient is by using local police and EOC centers
- DCI
- Per Geraldine (DCI) - DCI does not have all the different departments like FKC; emergency disaster situations are handled by their Risk Management
- From the clinical side, as soon as hurricane season starts, they make sure their social workers have the most updated patient information (current address of where they are living and cell phone number); ask for multiple contacts of possible places they may go in case of a hurricane
- Then if the clinical administrator knows there is a storm coming, the corporate administrators are contacted
- 2 days before they know the storm will hit, DCI calls every patient to confirm their plans, where they are staying, if no place, DCI will find a shelter for the patient
- If a DCI clinic - they contact patient and prepare them to transfer out
- If a Non-DCI clinic - DCI contacts the clinic and makes sure they are able to accommodate the patient and sends patient contact information
- The clinics have generators as backup and the administrators are to make sure the clinic has water and fuel
- After the storm/disaster, DCI starts contacting the patients to inform the clinic is reopened and what the patient's plans are for returning to the clinic
- Corporate Administrators meet every day to talk through the status; making sure the patients can plan to come back to the clinic for dialysis treatments
- The local administrator completes the ESSRs and emails them
- An emergency number is distributed to their patients along with a report of their information
- IT nurses remain on call 24/7 and provide any patient information to the clinics as needed if the patient does not have the information with them
- DaVita
- Per Tom Bradsell
- Similar to DCI and FKC processes, they communicate to the patients prior to the storm/hurricane and monitor the activity of the storm
- Utilizing text messaging systems to gather and provide patient information/status
- Data is collected on a daily basis for the ESSR from their facilities and local leadership teams
- The emergency management team submits the ESSR to KCER via email
- Pain points
- FKC
- They encourage their patients to evacuate tens of miles away not too far where they are not familiar with their surrounding area
- There are patients that go outside of the impact zone; for those close to the impact zone, the clinical manager, DO and IVP will work with the medical director to approve any operating hours
- If only 1 facility is open, the facility could be running 24/7 until relief is provided which may also lead to having to decrease the dialysis flow rate because of the high number of patients needing dialysis
- A pain point would be transportation issues getting patients to and from dialysis centers
- Transportation issue is their number one pain point
- Another pain point is the issue of waste pick up in the dialysis centers; hard to get their regular waste vendors to come and pick up solid waste and regulated medical waste
- Have had to pay a lot of money to get local folks to get rid of the waste \
- Another pain point is patients do not know the name of their dialysis facility or the address; they can describe the location but pinpointing the exact dialysis center is hard when there are so many in the area
- EQRS does have the location of where a patient is dialyzed
- DaVita
- Transportation is also a pain point for DaVita
- No pain point with their plans and processes because they can be adjusted accordingly
- DCI
- Transporation is also a pain point for DCI
- A challenge is that there is a set schedule that cannot be altered; therefore the problem of those that are receiving dialysis treatment "after hours" of the transportations operating schedule
- Dan Kayhart mentioned the EQRS ADO is still in the process of defining what they will be doing/developing
- Question for the EDIs if a dashboard that provided information such as a particular incident; various facility information (open/closed status, capacity, who doesn't need to move patients, etc. Would it be helpful?
- DaVita would find it helpful and also to include hospital information
- FKC would also find it helpful but the concern may be who would maintain the dashboard how timely would it be?
- If local facilities would be updating the dashboard and they are in an impact zone, what would be happen if they have no internet connectivity?
- US Renal (Tom Woodworth) mentioned a pain point for them is connectivity; they have trouble getting the information fron the field funneled up and broadcasted out; having the dashboard would add an additional pain point if not planned correctly
- Ideally, the information would come the individual facilities (the field) and there needs to be a sort of backup method
- DCI (Geraldine) suggested a way to search on a patient to find out where a patient is having dialysis treatment?
- One problem with having the capability to be able to search and find where a patient is having dialysis treatment is that not all patient information is entered into the system right away during an emergency response situation. There may be a delay in getting the patient's information updated in the system
- Kathleen asked if all the questions are in part for the vision for batch having part of a role in the collection and recording of this data to EQRS or a dashboard? Need to make sure the vision is to relieve a burden to the EDIs/facilities in capturing the information and not allowing for more work during a disaster
- Adrienne Ray mentioned EQRS ADO is still in the requirements gathering phase, more meetings will take place; EDIs will be involved; this will be a collaborative effort
- Lisa asked - As far as having a centralized system for emergencies, are there things that if you could communicate it in a rapid manner to get help, what would those be?
- DaVita - it would be nice to have a real-time system or dashboard in a secure network where they can provide information quickly and explain the situation
- Are there any reports that will be beneficial other than a dashboard?
- Report on facilities status and providers
- For a dashboard, what levels of access (roles) would the EDIs need to see?
- Would it be limited based on geographical location? incident command teams come from all over the country
- Suggestion to have the dashboard access open and not be geographically based
- Would like to have CMS assist in getting volunteers, RNs, patient techs get through the clearance process quicker
- It can be a view access for facilities and local teams
- Providers will have access to so that their representative can update the informationl; an admin data entry access
- Would there be completely new roles for the Emergency Module only?
- Per Lisa, nothing has been determined; this is still very early in the process
- Nathan suggests using a data standard for emergency management; FEMA may have something; this allow for consistency and the sharing of data with other systems to be almost seamless data
- The idea of having a roll (view only role) would be good for the ability to look up a patient and see where that patient came from and basic patient information; sometimes a patient will show up at a clinic for dialysis because other clinics/hospitals are full
- DCI, FKC and DaVita have guest services that can provide assistance of patients on where to go and provide their medical records to the facility if necessary
- Would be nice to have a role that allows access to locate a patient and have a report to define what we need to see on a patient in order to dialyze the patient; be able to upload the report to the clinic to have the information that is in EQRS
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