Ophthalmologists may not be able to predict the next calamity to strike, but they can be prepared for them. One of the sessions at Mid-Year Forum 2019 explored the resources available to physicians who want to prepare for the unexpected.
Abstract
Fires, hackers, hurricanes and shooters are in current events and ingrained in today’s lexicon. Learn how to prepare and protect yourself, your family, and your practice from real and virtual threats by employing emergency preparedness strategies. At the end of this interactive, fast-paced session, you will receive access to a toolkit containing incident management resources, covering common natural disasters to man-made events such as cybersecurity and active shooter scenarios – real tools that you can put into practice when you return home.
Background Information
Moderator Daniel J. Briceland, MD, Senior Secretary for Advocacy, American Academy of Ophthalmology introduced the hearing with a bucolic slide focused on the scenery and fauna of his drive to work in Arizona and then transitioned to examples of possible threats that the speakers would cover that could affect attendees at home, including natural disasters, cybersecurity attacks, and active shooter events.
Summary of Comments from Guest Speakers
Real-Life Experiences with Disaster Management
Natalio J. Izquierdo, MD, past president, Puerto Rico Medical Association
Dr. Izquierdo led his session by stating that disasters can strike and mentioned examples (e.g., 9/11, earthquakes and hurricanes) and how these can they can impact patients from an ophthalmology perspective. He covered the following topics:
- Infrastructure
- Examples of basic infrastructure components that were lost during Hurricane Maria included power, water, and communications.
- Personal loss
- Effects included stress from dealing with family needs during a disaster.
- Professional loss
- Without power or the internet, electronic health records (EHRs) didn’t work, and hard copies of patient records weren’t available. Medical supplies and samples were scarce.
- Research and residency programs were affected by protocol interruption and the cancellation of lectures respectively.
- At supra-tertiary hospitals, patients with retinopathy of prematurity (ROP) in the neonatal intensive care unit (NICU) were at highest risk of being adversely affected.
- Supranational organizations and local support
- Various external organizations provided additional support to include the Academy and Pan-American Association of Ophthalmology (PAAO).
- Local support to the residency program included fundraising events and the donation of equipment.
Cybersecurity: Your Exposure Risks, Example Scenarios to Consider, and Best Practices to Guard You and Your Practice
Susan Doucette, assistant vice president of underwriting, NAS Insurance Services
Ms. Doucette provided an overview of the importance and significance of cybersecurity to ophthalmology practices. The core areas she covered in her presentation included:
- Cyber Landscape – Understanding Your Exposure
- In 2018, it was reported that 1,244 breaches affected over 446 million records, an increase of 126% over 2017.
- Cyber Claims Trends
- Examples of the types of breaches mentioned before & after pictures, employee carelessness and/or negligence, employees & social media, ransomware, rogue employees, phishing schemes, and lost/stolen devices. Negligence was listed as the most the common cause.
- Claims Scenarios
- Scenarios included the exposure of metadata in multimedia content, loss of a computer tablet with PII, effects of ransomware attacks, and a phishing attack resulting in a large financial loss.
- Best Practices
- Best practices both for users and IT Departments were reviewed by Ms. Doucette.
Active Shooter Planning and Response in a Healthcare Setting: Learn How to Survive a Shooting Event, While Dealing With the Unique Challenges Associated With a Healthcare Facility
Scott Cormier, vice president of Emergency Management, Environment of Care and Safety, Medxcel Facilities Management, Ascension Holdings
Mr. Cormier provided an overview of workplace violence and with a focus on active shooter events in a healthcare setting. The core concepts covered in his presentation included:
- Definition of healthcare workplace violence
- Can be defined as violent acts including physical assaults and threats of assaults directed toward persons at work or on duty.
- Healthcare workplace violence statistics
- Incidents of serious workplace violence were four times more common in healthcare than in private industry.
- Active shooter: definition and response
- Misnomers and misunderstandings associated with the definitions of active shooters were addressed such as a differentiation between a person with a gun and an active shooter. Using this definition, the actual number of healthcare related active shooter incidents from 2000-2019 would be 8.
- Definition of an Active Shooter: One who is actively engaged in killing or attempting to kill people in a populated area.
- Common issues were discussed to include the concept of duty to attack vs. abandonment.
- The tactic of run, hide, and fight was discussed. An emphasis was made to focus on moving (running) as its difficult to hit a moving target. During a Q&A session, a participant recommended running in a zig-zig pattern, Mr. Cormier disagreed as research indicated that a zig-zag pattern would be riskier and expose the runner more (unless the runner was a world-class sprinter); essentially, a straight-line run to escape the line of fire would actually be the better (best) option.
- Implementation strategies
- General concepts related to current knowledge were presented.
- Planning strategies to include the need for an evacuation policy with procedures and the importance of knowing local emergency response agencies were emphasized to include an understanding as to what law enforcement would do upon arrival at the scene.
- Though It’s great to implement a plan to deal with an active shooter, it can be tougher to maintain it.
Summary of Audience Comments
- Thank you for developing the toolkit card. Very helpful and convenient.
- The presentation on Hurricane Maria in Puerto Rico was interesting and made me think.
- I thought I wouldn’t enjoy the cybersecurity topic, but I really did.
- This is different from other sessions, but it was quite useful.
- I liked the active shooter presenter as he was a straight shooter and said it like it is.
- The active shooter training is great. Can I get a card?
- I’m going to take these (toolkit) cards back to my office.
High Priority Objective
- Attendees can download resource toolkit listed on the cards handed out during the session at aao.org/MYF19-EPDP.
- From there attendees can review relevant resources for themselves, their family, and their practices.
Read the full Mid-Year Forum 2019 Report: View as webpages or as a PDF (360 KB).