When Hurricane Isaac hit New Orleans a month ago, while some government engineers may have been holding their breath watching southern Louisiana's levee system, officials at the Office of the National Coordinator were watching news media accounts of flooded-out evacuees and wondering if they’d be able to access their health records.

If the some 60,000 people evacuated from Louisiana and Mississippi were displaced and needed healthcare outside of their health networks, asked ONC program manager Lee Stevens in a recent blog post, “Are we ready?”

Isaac ended up as a category 1 storm, which was just a nuisance for some bayou residents but probably caused upwards of $1.5 billion in onshore property damage, the Los Angeles Times wrote. Even as New Orleans’ levees proved sound, some 200,000 Louisianans are still vulnerable outside the levee systems, as LA Times noted. When Katrina and then Rita hit Louisiana and Texas in 2005, some healthcare systems were either chaotic or struggling to function, and about a million people were evacuated from the disaster areas.

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With that in mind, Stevens is promoting the ONC’s health information exchange and disaster preparedness report, a sort of emergency legal, IT and governance guide for Gulf states to coordinate for health information sharing in the event a natural disaster leaves large numbers of Americans stranded. For instance, how exactly could an Alabama provider treating an evacuated Mississippian access the person’s electronic records?

Trying to offer a guide through all the legal and procedural steps to answering that question, the ONC and representatives from Alabama, Arkansas, Florida, Georgia, Louisiana and Texas created “SERCH,” the Southeast Regional HIT-HIE Collaboration.

Government agencies and providers in Gulf states should start developing coordination procedures and leadership structures, the report recommended, and should consider signing a memorandum of understanding establishing a waiver liability that would have HIPAA become the default legal structure across states in an emergency. To expedite patient privacy, security and other concerns, states should consider the Data Use and Reciprocal Support Agreement, the report recommended.

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With some climate scientists predicting increasingly intense hurricanes, healthcare leaders are using concerns about the risk of disasters to promote HIE connectivity.

“When the next hurricane strikes and people are forced to leave their homes for someplace else in the state, will it be [worth] the risk to their safety and well being to leave their paper medical records soaking wet? Or will the value of accessing secure, electronic records become apparent in the days following the disaster?” Sullivan wrote, noting that the growth of “networks of networks” in Florida shows promise.