NEW ORLEANS – Federal health officials are working to open a database of prescription drug records to help Hurricane Katrina (search) evacuees piece their health care back together.
The project, still developing three weeks after the disaster, underscores the glaring reality that the hurricane destroyed medical records (search) of untold numbers of people, possibly complicating treatment decisions for years to come.
And it's focusing new attention on the need for computerized medical records, accessible in an emergency even if the patient is far from home or their doctor's office no longer exists.
"There may not have been an experience that demonstrates, for me or the country, more powerfully the need for electronic health records ... than Katrina," Health and Human Services Secretary Mike Leavitt (search) told The Associated Press on Monday.
"This is not going to be a short-term problem," he said, pledging to help Gulf Coast states rebuild better records systems.
The federal government's goal is to give most Americans computerized medical records within 10 years. But it's so expensive and technologically challenging, since systems must be compatible so the records can be read by competing clinics and hospitals, that only a fraction of health providers today are paperless.
As a result, doctors struggle to care for hurricane evacuees without knowledge of past treatments or even all the illnesses they have. Even determining daily medicines is a challenge.
"A lot of people walk in and say, 'I take a little blue pill,"' without any idea what it was, said Dr. Bethany Gardiner, a pediatrician from Santa Barbara, Calif., who is treating evacuees in Baton Rouge, La.
Last week, Dr. Joseph Mirro of St. Jude Children's Research Hospital in Memphis was reconstructing complicated chemotherapies for 80 evacuated children with cancer. Their treatments are precisely timed — they can't be just started over. He tracked down some oncologists who fled flooded New Orleans (search) with treatment records, but relied heavily on parents' recall and own notes of their children's treatments.
"I honestly feel quite comfortable that the worst-case scenario is we delayed treatment" for some children, he said. But there was "a lot of flying by the seat of your pants to get it right."
One bright exception is that even though the New Orleans VA Medical Center flooded, electronic medical records for 50,000 patients of that hospital and surrounding veterans' outpatient clinics survived.
On Sept. 1, three days after Katrina hit the Gulf Coast, a Veterans Affairs Department computer specialist was airlifted from New Orleans carrying backup tapes of all the records, which by the next night had been re-entered into computers in Houston.
"Every single thing on that computer was saved," said Charlie Gephart, records chief for the South-Central VA Healthcare Network.
Moreover, evacuees could access some records even at the height of the disaster, Gephart said. His office put patient prescriptions and other data tracked at a separate location onto a secure Web site as an interim solution.
For other evacuees, Leavitt's office is developing two programs that he hopes will help soon:
—A database of prescription drug (search) records from retail pharmacies and pharmaceutical benefits managers, for 90 days preceding the storm. Large drugstore chains keep such databases, meaning evacuees who bought their medicines at a single chain could get refills fairly easily. But a national database could provide a one-stop check for people who buy medicine from more than one store or by mail.
—A pilot project to generate electronic medical records of care now being provided in certain hurricane shelters. No one knows what records, if any, survivors receive as they shuttle from shelter to shelter, seeing different volunteer doctors in each spot.
Leavitt saw such as project in action at Houston's Astrodome (search), where within 48 hours of opening Texas hospital workers set up computer-generated records of evacuee care, including the results of laboratory tests beamed offsite for analysis.
Just having records on a computer isn't enough, Mirro stressed. His own hospital backs up its records on a second computer server and with tapes recorded out of town. If both servers are destroyed, it would take about two days to retrieve the tapes. He's now wondering whether even that's enough.
"In a hurricane zone, you have to have multiple contingencies, and we will have to have more in the future," the VA's Gephart said.
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