Our hearts and unwavering support go out to all who have been affected by the fires across Southern California. At ProAssurance, we stand united with you—our dedicated medical community—as you grieve this devastating loss, continue caring for patients, and begin to rebuild.
We hope the following risk reduction strategies will be helpful as you navigate patient care in the weeks and months following this tragedy.
Patient Follow-Up
As you are able, review schedules to determine which patients have acute issues and upcoming or missed appointments. Attempt to contact patients, prioritizing by condition urgency. Document the communication and any resulting action or status. If your office is unable to see patients, document where you instructed patients to go (e.g., shelter, clinic, urgent care, emergency department), or if other arrangements were made (e.g., home health visit, telehealth visit).
Patient Hand-Offs and Transfers
If your facility needs to evacuate patients, tracking those patients is important. Documentation to accompany patients should include critical information to support continuity of care and treatment such as patient name and date of birth; allergies; medications; problem list; emergency contact; a copy of the most recent discharge or care summary; copies of the latest lab reports; and primary care physician information.
Medication Management
Patients may need replacement prescriptions for medications they left behind, or they may be due for refills. You may also encounter patients who have been displaced and are seeking care in your facility or practice. The prescription management process should be handled carefully and in compliance with California law and regulations.
Damaged or Destroyed Medical Records
Many healthcare facilities and physician offices will be trying to recover and restore damaged records in the aftermath of the fires. Records may not only sustain fire damage, but water damage from fire-fighting efforts as well. Before investigating potential damage to medical records, contact your general liability or property insurer for information and recommendations. Ensure that your record storage location is safe to enter and execute HIPAA business associate agreements with any vendors hired to help recover records.
If you cannot salvage medical records or otherwise reconstruct them via electronic data recovery, you should begin the process of recreating them to the best of your ability. Approach other entities that store your patients’ PHI in their own databases and record-keeping systems. For example, pharmacies, consultants, prior treating physicians, third-party insurers, transcription services, and hospitals most likely have PHI they can provide you with. Health Information Exchanges can also assist with rebuilding records through their Consolidated Clinical Document Architecture (C-CDA).
During the record reconstruction process, inform patients in writing of their PHI destruction; date the reconstructed record with the current date; identify the record as reconstructed; and contact third party insurers to determine whether they will require an attestation form. Finally, be sure to maintain thorough documentation of your medical record and data damage recovery efforts.
Additional Resources
California Medical Association: CMA working to ease burden on physicians and patients affected by Southern California wildfires
CalHHS: CalHHS Emergency Resource Guide - California Health and Human Services
Listos California, the Governor’s Office of Emergency Services: Be Disaster Ready, California
Pharmacy Times: As Wildfires Spread Across California, Pharmacists' Role in the Crisis Proves Essential
Becker’s Hospital Review: Hospitals and California wildfires: What to know
Assistant Secretary for Technology Policy: Health Information Exchange