Lesson From Katrina: Patient Information Is Key

As the hurricane season approaches, medical experts turn to better organization and technology

MONDAY, May 8, 2006 (HealthDay News) -- The 2006 hurricane officially begins June 1, and health care professionals are still dicussing the lessons learned during Hurricane Katrina and its aftermath.

It wasn't the injuries that stymied relief efforts in Louisiana, said Dr. Lynn Witherspoon, chief information officer for the Ochsner Clinic Foundation, a healthcare system with 25 clinics across the region. The biggest problem was getting medical records so that patients could have the medications that keep them going.

Witherspoon joined other health information officers in a discussion about patient information the annual conference of the Healthcare Information and Management Systems Society (HIMSS) last February in San Diego. In a session that included a number of medical and technology experts, the discussion on how to treat patients more effectively involved having a person's medical history available.

"In the first week after the storm, except for injuries, the health care needs were all about filling prescriptions," Witherspoon said.

Ochsner patients may have fared better than most. Their records came back on line a short time after the hurricane, so that doctors and pharmacies could look up prescription information for patients who were forced to leave their city or state.

But hundreds of thousands of patients suddenly found themselves with no access to their heart, diabetes, blood pressure and other life-sustaining drugs. Many had to wait and then virtually start over with doctors they didn't know who then began the treatment process from scratch.

Eventually, a makeshift electronic records repository was put in place that pretty much saved the day, Witherspoon said. With the help of the big companies that do the billing for most pharmacies and insurance companies nationwide, the federal government was able to gather and post individuals' prescription information on a secure Web site called Katrina Health, accessible to health care professionals.

"Access to a complete and accurate medication list was incredibly powerful, because patients didn't know what they were taking, or their drugs had been in the flood water, " Witherspoon said.

Now, many states, including Louisiana, are setting up central data bases that can be used in just this kind of emergency.

"People really should have the right to expect that medical records would survive these disasters and be portable to patients wherever they find themselves," said Witherspoon.

Medical records were also a problem for refugees in Dallas, said Pam NcNutt, senior vice president and CIO of Methodist Health System of Dallas.

But emergency care was accessible because emergency rooms were not inundated with people who needed non-emergency services.

A triage station was set up at the Reunion Arena in Dallas. The equipment wasn't high tech, but staff and volunteers were able to talk to people, find out their concerns, and determine who needed hospital care, she said. For the most part, what they needed were their regular medications.

"It was a great way to triage people and take care of basic needs, which kept them out the emergency department," she said.

McNutt, who along with Witherspoon spoke at the recent meeting of the Healthcare Information and Management Systems Society in San Diego, said that a larger issue has yet to be solved: what to do about credentialing the doctors and nurses who volunteer to help in times of trouble?

States have different licensing requirements, she said, though the nurses and doctors licensed in one can be just as able as those from another. But treating patients in a state in which they are not licensed is against the law.

Some protections are offered under what are called "Good Samaritan" laws, designed to protect from liability anyone who reaches out to injured or ill people.

But that's just not good enough, McNutt said. "This is national issue that requires a national credentialing data base," he said.

And both doctors said the time to put such tools in place is now, before another disaster strikes.

More information

Visit the U.S. Centers for Disease Control and Prevention's hurricane health information center for additional updates on being prepared.

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