Online Program

Utilization of Healthcare Services after Hurricane Sandy: The Manhattan VA Medical Center and Telehealth

Tuesday, November 3, 2015 : 4:45 p.m. - 5:00 p.m.

Claudia Der-Martirosian, PhD, VEMEC, Veterans Emergency Management Evaluation Center, North Hills, CA
Anita Yuan, PhD, MPH, Health Services Research and Development Center, West Los Angeles VA Healthcare Center, Los Angeles, CA
Sarah Dalton, MPH, VEMEC, North Hills, CA
Aram Dobalian, PhD, MPH, JD, Veterans Emergency Management Evaluation Center (VEMEC), Veterans Health Administration, North Hills, CA
Anne Griffin, MPH, BSN, CNOR, Veterans Emergency Management Evaluation Center (VEMEC), Veterans Health Administration, North Hills, CA
Karen Chu, MS, Health Services Research & Development (HSR&D) Center of Excellence for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System (VAGLAHS), North Hills, CA
Introduction: Hurricane Sandy caused 157 deaths in the U.S. and tens of thousands of injuries. Approximately 6,300 patients from 37 healthcare facilities evacuated NYC due to flooding and/or had power outages. The Department of Veterans Affairs Medical Center (VAMC) in Manhattan evacuated in advance of the storm and temporarily halted all inpatient and outpatient services due to catastrophic flooding. As part of an integrated healthcare delivery system, VAMCs are able to relocate patients from one facility to another during an emergency.  We examine how closure of the Manhattan VAMC shifted patient care to neighboring VAMCs in Brooklyn and Bronx.  

Methods: Using data from VA Corporate Data Warehouse, specifically, visit date and time, facility location, and primary clinic, we present the daily count of patients as well as the proportion of visits compared by six clinic groupings (primary care, specialty care, mental health, ER/urgent care, ancillary diagnostic and telephone care) 12 weeks pre- and post- evacuation of Manhattan VAMC. 

Results: There was a 50% increase in the use of VA Telehealth services at Manhattan VAMC and only a modest increase (5%) in the use of diagnostic services for both Brooklyn and Bronx VAMCs post-Sandy.

 Conclusion: In the case of these three VAMCs, Hurricane Sandy shifted both patient load and volume of care. However, we find that patient care shifted in type of care towards Telehealth rather than in geographic location to neighboring VAMCs. These findings highlight the potential for this new technology to improve access to healthcare services during emergencies.

Learning Areas:

Advocacy for health and health education
Other professions or practice related to public health

Learning Objectives:
Analyze patient load and volumne of care before and after Hurricane Sandy Define Telehealth List potential problems when using Telehealth List positive attributes of using Telehealth Assess the benefits and pitfalls of Telehealth

Keyword(s): Emergency Preparedness, Veterans' Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Associate Director for Research at VEMEC and have worked at VA for the past four years as lead quantitative researcher for several projects including the assessment and evaluation of impacts of hurricanes on continuity of care at VA using Corporate Data Warehouse (CDW) administrative and clinical patient data files.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.