Hurricane Harvey has dealt a tremendous blow to the residents of Houston. But for the most part, area hospitals have continued operating despite the threat of encroaching flood waters.

Houston Methodist in the Texas Medical Center took to Twitter on Sunday to dispel a rumor that it was flooding. However, on Monday, the organization also announced that elective surgeries for all its locations were cancelled through Wednesday.

Likewise, MD Anderson Cancer Center locations remained closed on Monday for outpatient services and appointments because of severe weather, while its inpatient hospital care areas were open.

“MD Anderson Cancer Center will remain closed for outpatient services, appointments and surgeries at all Houston-area locations through Tuesday, August 29,” said Karen Lu, MD, senior vice president and chief medical officer, in a written statement. “High water conditions persist in the Texas Medical Center, and travel should not be attempted. All leaks reported yesterday are under control, and patient care has not been impacted.”

During Hurricane Sandy in 2012, some hospitals in the New York City area were unable to access their electronic health record systems because of power outages that affected data centers or other buildings where patient data were stored. But so far, health IT systems at Houston area hospitals have weathered the storm.

Darrell Pile, CEO of the Southeast Texas Regional Advisory Council, which established a Catastrophic Medical Operations Center to ensure the continuity and support of healthcare infrastructure in the region, says he is not aware of any hospitals losing their EHRs.

Similarly, Lance Lunsford, chief marketing and business development officer at the Texas Hospital Association, says there’s no indication that EHR systems have been affected when it comes to hospital operations in the wake of the hurricane.

For its part, a spokesman for MD Anderson noted that its EHR is working fine. And Kathryn Williams, director of corporate communications at Memorial Hermann Health System, reports that their healthcare organization has not experienced any interruptions in its EHR system.

Karen DeSalvo, former National Coordinator for Health IT, is closely watching the natural disaster as it unfolds, noting that she grew up in Texas and has family and friends there.

“I haven't heard of any EHR breakdowns,” says DeSalvo. “The Texas health system seems thus far to be resilient to the intense and unprecedented stress of Harvey. Like many hospital systems, they responded to lessons we learned in Katrina and they learned from Alison and are weathering the acute event. This is a reminder to all in the healthcare sector to build with climate resilience in mind.”

She points to a December 2014 document issued by the Department of Health and Human Services, a toolkit that has some “great tips” for creating sustainable and resilient hospitals in the face of climate change.

Andrew Gettinger, MD, chief medical information officer in the Office of the National Coordinator for Health Information Technology, contends that there have been other natural disasters in which EHRs have actually provided some resilience. “Each organization needs to look at what they are at risk for in terms of natural disasters and develop sufficient emergency contingency plans,” recommends Gettinger, including proper downtime procedures, policies and practices as well as backup systems.

“We are in communication with clients impacted by Hurricane Harvey and continue to work with them in various stages of their contingency plans,” says Marlene Bentley, spokeswoman for EHR vendor Cerner.

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According to the Texas Hospital Association, the state’s hospitals have benefitted from capital investments reinforcing infrastructure and best practices learned following Hurricane Ike in 2008 and Tropical Storm Allison in 2001.

“These emergency preparedness investments are significant,” said Ted Shaw, president and CEO of the Texas Hospital Association. “They represent hospitals’ commitment to their role as a trusted resource and front-line responder when disaster hits. THA is working with federal, state and local agencies, including the Regional Advisory Councils, Federal Emergency Management Agency and Homeland Security to coordinate response activities and support our member hospitals.”

Flood doors, part of the safety upgrades implemented following Tropical Storm Allison in 2001, were deployed in recent days at Memorial Hermann-Texas Medical Center, Texas Children’s Hospital, TIRR Memorial Hermann Hospital, as well as the University of Texas Health Science Center to protect their lower floors from rising water.

Nonetheless, despite investments in such flood protections, some Houston hospitals were not able to withstand the wrath of Mother Nature. Bayshore Medical Center moved its 196 patients to surrounding hospitals and in the process suspended all services including its 24-hour emergency medical center.

In addition, Ben Taub Hospital issued an evacuation call on Sunday for its patients after it experienced basement flooding—the facility is still trying to evacuate about 20 critically ill patients out of 350 total, and food is about to run out, according to press reports.

Williams says all of Memorial Hermann Health System’s major hospitals are still open and operational, with the exception of one hospital.

“Due to the severe and heavy rainfall, as well as the emerging threats posed by the rapidly rising Brazos River, we took the proactive step earlier (on Monday) to temporarily close Memorial Hermann Sugar Land Hospital in an effort to ensure the safety of our employees and our patients,” she says. “Patients are in the process of being safely transported to a nearby facility, Memorial Hermann Southwest Hospital, where they are continuing to receive access to high quality care.”

While Pile could not give firm statistics on how many hospitals have been evacuated to date, he estimates the number at perhaps a dozen or so, adding that on Monday about five facilities began evacuating.

“It appears that the majority of these hospitals have hardships that have led them to declare an internal disaster,” observes pile. “That means some of their normal services are compromised due to internal needs, likely due to flooding. If a situation worsens, they may declare a need to evacuate.”

According to Pile, the situation on the ground could get worse before it gets better for the more than 100 hospitals in the 25-county area that the Southeast Texas Regional Advisory Council oversees.

“The duration of this storm may now extend through Friday as the storm turns east, goes back over the coast, and re-enters near Beaumont,” he says.

DeSalvo knows firsthand about the devastation of hurricanes, given her experience with Katrina in New Orleans, which decimated the city’s healthcare system and flooded all the major hospitals.

“The long-term work that happens in recovery of addressing the mental, physical and social health impacts needs to begin right away given the likely significant impact on the public’s health,” concludes DeSalvo, who following Katrina helped set up emergency card-table clinics to care for the displaced populace. “The impacts will be on not only those they serve, but on the caregivers themselves making the work that much more challenging. We should all stand ready to help.”

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