One of the major differences between a healthcare provider and a healthcare payer is that the provider must take into consideration the continuity of services to patients. The most effective way to accomplish this continuity is to enter into a reciprocal agreement with one or several other local medical facilities. In doing this, it is important to understand each participant's typical throughput rate for each particular service (e.g., number of beds occupied per day or number of dialysis treatment per day). By understanding throughput rates and capacity of each participant, a realistic choice of participants and expectations can be achieved.In order for this type of reciprocal agreement to be effective, there needs to be a method of seamlessly integrating the service scheduling of one institution into the other's scheduling. For instance, if hospital A has a set schedule for patients to receive computerized axial tomography (CAT) scans, that schedule must be replicated and stored off-site on a regular basis so that if a disaster did strike, that schedule could be transferred to the hospital B where the appointments could be integrated with the alternate facility's schedule of appointments. Additionally, copies of the affected patients' medical records would have to be transferred. The transfer of these records and schedules would be cloaked with the protections afforded by the HIPAA regulations.Another component of the reciprocal agreement would be to grant admitting privileges to doctors from the hospital (upon the declaration of a disaster) to the hospital with which the reciprocal agreement was reached. If this is pre-approved by the medical boards of each hospital, then, upon the declaration of a disaster, patient care can continue with as little disruption as possible.
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