A week after a tornado slammed into St. John's Regional Medical Center in Joplin, Mo., in May, a fully digital, 60-bed temporary field hospital was up and running across the street.

Critical to the quick turnaround was a centralized data center that houses electronic medical records for Sisters of Mercy Health System hospitals and clinics in four states, including St. John's. Records from St. John's had migrated from a data center next to the hospital to the $60 million centralized warehouse just a few short weeks before the tornado hit. Mercy was also one of the first organizations to reestablish communication services and computer networks.

The rapid response was due in large part to systemwide disaster planning. The storms that swept through the Midwest in late spring certainly serve as a reminder that hospitals need to be vigilant about their disaster planning scenarios, especially as more and more care is dependent upon fragile communication systems.

"For a long time we've been working with Verizon and AT&T, our communications providers, and other partners that provide technology services like Cisco, so that we have the capability of leveraging those relationships in time of need," says Will Showalter, chief information officer for Sisters of Mercy.

He also notes that plans were in place for St. John's to rely on a sister hospital in Springfield, Mo., to run census data and print out patient medical records in the first hours following the disaster. The tornado hit St. John's at 5:40 p.m., and "by 7 that evening, we were already in the throes of producing that hard copy," he says.

Patty Skoglund, director of disaster preparedness for Scripps Health in California, says that cultivating partnerships ahead of time is key. Her team — which was on the scene after Hurricane Katrina, the Haiti earthquake, and Southern California wildfires — has ongoing communications with the Department of Homeland Security, the local nursing services authority and the California Emergency Management Association. Scripps is also part of a consortium with local corporations including Qualcomm and Time Warner; together, they work on plans for helping each other and sharing resources during a disaster.

Additionally, preplanning includes clinical impact analysis for all electronic applications, which means figuring out how patients will be affected if an application goes down, how to proceed in such an event, and prioritizing which technology is most necessary for patient care.

"It's not your HR system, it's not your parking gate," says Clark Kegley, Scripps' senior director, service delivery, for information services. "It's laboratory, radiology, pharmacy, and then your base EMR for orders and results. You're going to find that pretty consistent from hospital to hospital."