When we realized that Manati, Puerto Rico-based Doctors' Center Hospital was one of the top five small hospitals in the 2017 Best Hospital IT Departments, we weren't sure whether they'd have much time to talk to us with the ongoing crisis in the wake of Hurricane Maria still gripping the island.

Thankfully, Chief Information Officer Pedro Rios-Mercado was able to find some time to speak with us over a spotty phone line, despite the fact that the hospital was "still fighting with our electricity" five full weeks after the storm had made landfall on Sept. 20.

Doctors' Center Hospital has four locations across the island, but Manati is its main headquarters.

"Every hospital in Puerto Rico was hit," Rios-Mercado said.

When we spoke on Oct. 25, Manati had been able to run its Meditech EHR with help from a generator, but the other hospitals had been forced to return to paper records for weeks since the hurricane.

Merely maintaining daily operations had been a challenge, to put it mildly. The generator meant it took more than an hour and a half to get the Meditech system up and running. And "every other day we have generator maintenance when they shut the generator down to change the oil, etc."

The Doctors' Center IT staff had barely left the hospital since September 19.

One gratifying fact to emerge from the crisis is that doctors actually like EHRs better than some may have previously assumed, Rios-Mercado said. "To our surprise, in Manati at our headquarters, the physicians prefer to wait until the system goes up," he said. 

Given EHRs widespread reputation for being kludgy, Rios-Mercado said it’s ironic that just as the hospital needed free-flowing data the most, it was hardest to come by, and physicians are left clamoring for their EHRs and complaining about having to use paper.

"We are about 250 licensed beds, but right now we are at 270 patients," he said. "So we are over capacity. We need the system to run efficiently more than ever and need access to information more quickly than before.

"We have just a quarter of our bandwidth," he added. "With communication, it's like we're in the '80s or '90s."

Amid the myriad challenges, the 10-person IT staff at Doctors' Center Hospital has been doing terrific work. "They are 100 percent engaged with their work,” he said. “They love their work, even without electricity."

The hospital is technologically advanced. It's the first in Puerto Rico, for instance, to have achieved Stage 6 on the HIMSS EMR Adoption Model.

So it's Rios-Mercado's goal to get back up and running soon, pursuing the initiatives it would be focusing on if not for the storm, including meaningful use, telemedicine, wearables, improved EHR usability for physicians and, especially, patient engagement.

"Our next big project was patient engagement," said Rios-Mercado. "That will be my biggest item on the shopping list for the HIMSS convention in Las Vegas."

When we suggested that hopefully by then he'll also be able to squeeze in a well-deserved vacation before or after HIMSS18, he laughed and said he agreed. But in the meantime remains a lot more work to do.

"Two Category 5 hurricanes in a row – that was our biggest nightmare," Rios-Mercado said. "And right now we're still running, thanks to our staff, thanks to our executives, and our vendors are still working with us because they know how strong we are with our culture and how compromised we are with our patients.

Rios-Mercado added that Hurricane Maria has been an amazing learning curve for Doctors' Center Hospital and its IT shop. 

"I don't see anything more hard to fight than the kind of catastrophe we just have experienced. You don't know how strong you are until you face a big disaster like this. It's amazing that we're still up and running after that. I don't have words to express it. But we're still here."

Click here to learn more about how we chose this year's winners.

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com