Blame it on El Niño, Mother Nature — even managed care, if you prefer. Whatever its cause, the harsh weather that continues to plague much of the country makes the topic of salvaging water-damaged materials timely. The following tips come from Kay Myrtle, regional manager of Via Christi Medical Management in Wichita, Kan. Myrtle's advice aided recovery efforts at the University of Kansas Medical Center School of Medicine - Wichita, when some administrative and medical offices affiliated with the school were damaged by a flash flood last year, says Rick Kellerman, MD, chair of the Department of Family and Community Medicine. “This episode was a real learning experience,” he says.
Prepare for disaster
A thorough disaster plan and a well-organized disaster team are essential to an effective recovery operation. If you haven't developed a plan or appointed a team, you should make doing so a high priority. If you already have a plan, spring is a good time to review it.
Some of even the most detailed medical practice disaster plans don't sufficiently address how to recover water-damaged patient records. The steps presented in this article are guidelines intended to stimulate your thinking about the process. You'll need to do additional research and planning to develop protocols that will best minimize the damage to patient records. Myrtle suggests reading the booklet Procedures for Salvage of Water-Damaged Library Materials by Peter Waters, which may be obtained from the Preservation Office of the Library of Congress, Washington, D.C., 20540-4500; phone 202-707-5213.
Records recovery 101
Myrtle recommends following these five steps:
Begin by assessing the damage. Inspecting the area will help determine the equipment and labor that will be required to repair the damage. It's important to do your inspection quickly and carefully. Focus on determining the extent of the damage, the type of damage, areas that have been affected, the types of materials that have been damaged, whether the damaged items can be replaced and whether it's necessary to hire professionals to help salvage them. Take photos to document the damage.
Call your insurance carrier and make arrangements for the types of supplies and services you'll need for your recovery operation. Dehumidifiers are most effective in small, enclosed areas. Fans will also help to reduce humidity by circulating the air. Of course standing water must be pumped out of the area. For this hazardous task, it's best to get help from experienced professionals.
The most proven method of stabilizing water-damaged materials is to freeze them at about minus 20 F. This step will prevent water and mold from further damaging the charts and will buy you some time to plan the drying process. The sooner the charts are frozen, the better your chances of restoring them, so try to make arrangements for freezing them at a nearby location. The most efficient option may be for each member of the disaster team to take charts home and put them in the freezer. To prepare the charts for freezing, pack them in plastic bags that will prevent light exposure. Start with the wettest charts, then remove them in the order in which they're filed and inventory them as you go. Work quickly, but handle the charts carefully. Do not try to open the charts. Do not try to clean them. Mud and mold will be easier to remove when the charts are dry. Pack the bags of charts in boxes or crates, snugly enough to prevent excessive movement during transport.
The most successful method for drying frozen, water-damaged materials is freeze-drying. This method turns the ice crystals in and on the records into water vapor, which is drawn away from the records with vacuum pressure. Myrtle arranged to have the freeze-drying done by a local taxidermist for $250 a week. The process took five weeks. Be sure to talk with the person who freeze-dries the charts about maintaining patient confidentiality.
After they're freeze-dried, charts must be handled with care until they acclimate. During this time — at least six months, if possible — they should be stored in a well-ventilated, air-conditioned area.
The process of recovering water-damaged records is labor-intensive and expensive, but so is recapturing lost information. Converting to a computerized patient records system may be the ultimate form of flood protection for medical practices, provided records are regularly backed up and stored in a secure location. However, computerized charts are still not feasible for many practices. Paper records — and thorough disaster plans — will be necessary for years to come.