During Disaster, PULSE Exchange Helps Physicians Retrieve Health Data
By Alisa Pierce

Natural disasters. Cyberattacks. Public health emergencies. These crises often render physicians’ electronic health systems immobile, halting data transmissions critical for continuity of care – but a national health information exchange (HIE) system can help to crucial patient records remain accessible during emergencies.

HIEs are data exchange networks that allow physicians and other health care professionals to securely share and access electronic health information, including patients’ medical records, even if the information is housed at different health care systems across practices – as long as those entities and the physician or other health care professional are verified by, and connected to, the HIE.

Provided by the Texas Health Services Authority (THSA), the Patient Unified Lookup System for Emergencies (PULSE) nationwide HIE platform designed to support health care coordination an active disaster declaration (e.g., natural disasters and public health emergencies).

Through PULSE, patient data can be accessed remotely from smartphones, tablets, or laptops both in physicians’ offices and nontraditional health care settings like shelters and mobile field hospitals.

The system utilizes Texas’ statewide HIE service, HIETexas, overseen by THSA, to provide disaster response health care professionals access to real-time patient data – including lab results and medication, allergy, and diagnosis histories – in situations where patient information would otherwise be inaccessible. In addition to Texas Medicaid and the Texas Department of State Health Services, HIETexas can access data from participating hospitals.

Incidents like cyberattacks and natural disasters can disable a practice’s electronic system for hours, interfering with physicians’ ability to provide care, says Philip Bernard, MD, chair of the Texas Medical Association’s Committee on Health Information Technology and Augmented Intelligence.

That’s why “PULSE is an offering that has a lot of promise,” he told Texas Medicine Today.

“One of the biggest issues you have during a natural disaster is patients aren’t able to communicate their medical histories the way you would in a normal interaction,” Dr. Bernard said. “With PULSE, physicians should be able to understand, at least to some degree, previous emergency room encounters, problems, medication lists, allergies, and immunizations as [needed].”

Launched in Texas in 2021 with funding from the Centers for Medicare & Medicaid Services and the U.S. Department of Health and Human Services, PULSE is activated during declared disasters through collaboration with state partners, administrators, and users. To utilize its services, verified PULSE users, including physicians, can create a free account to retrieve patient information.

THSA CEO Phil Beckett says that because PULSE operates on infrastructure separate from physicians’ individual data systems, it remains available even when local networks are down – allowing care to continue during outages.

“If a hospital or clinical group loses access to the electronic health record because of ransomware, which sadly happens plenty, we could stand them up pretty quick … to have access to clinical records so that they can continue to function and take care of people,” he said.

Dr. Bernard said PULSE supports the flow of health information in a world where data communication is often “taken for granted” – until it’s too late.

“Texas is … leading the way in many aspects of health but we certainly have our fair share of natural disasters, and cybersecurity is a real issue,” he said.

THSA also administers HIETexas Emergency Department Encounter Notification (EDEN) system to assist in locating missing persons who may have been admitted to alternate care sites or shelters.

When a missing person is identified within an EDEN-participating facility, the querying user – often a physician – receives an alert that a match has been made. This allows a physician to act as an intermediary to reunite separated family members or connect displaced patients with their routine physicians.

For more information on PULSE and EDEN, including how to use and activate the systems, when it can be used, and for what purposes, visit THSA’s user guides. TMA offers information on how physicians can protect themselves from cybersecurity risks.