Securing access to patient records in times of disaster — learning from
27 June 2006
Washington, USA. Creating health information systems based
on simple open standards and allowing healthcare workers other than doctors
to access health records, are two of the key recommendations in a recently
published report on health care lessons learnt from Hurricane Katrina.
With the USA bracing for the 2006 hurricane season, the Markle Foundation
has released Lessons from KatrinaHealth, a report outlining lessons
learned in posting secure, online information about prescription drug
histories of evacuees from Hurricane Katrina in the aftermath of the
disaster in the USA's southern states around New Orleans in 2005.
"Although it is impossible to be fully prepared for a national disaster,
lessons were learned during Katrina that can help ensure that patients'
medication histories remain accessible in a private and secure manner in the
wake of a disaster," said Zoe Baird, president of the Markle Foundation, one
of the organizations that led last autumn's KatrinaHealth initiative. "It is
critical that government and private sector leaders work together to put
systems, technologies, and policies in place to ensure that this life-saving
information is securely, privately, and readily available to patients and
those who treat them anywhere in the country."
"Many question the nation's
preparedness for the hurricane season ahead, but the report provides
recommendations that should be put in place now to ensure medical records
can be accessed and much-needed prescriptions provided quickly in the wake
of a future disaster," said David Medvedeff, PharmD, MBA, president of
Informed Decisions, a Gold Standard company.
In the days following
Hurricane Katrina's landfall near New Orleans last August, a group of
private and public health and information technology experts created
online service for authorized health professionals. The website provided
access to evacuees' medication information in order to renew prescriptions,
prescribe new medications, and coordinate care.
To glean lessons from the
experiences of health care professionals and patients following Hurricane
Katrina, the Markle Foundation convened a group of industry and government
experts and prepared the summary report, which includes such key insights as
the need to:
- Foster immediate discussions regionally and nationally among
government health leaders, insurers, healthcare providers, and
information technology companies to determine what, how, and when
patient medical information can be shared securely and quickly in the
event of a disaster.
- Create electronic health information systems that are based on
simple, open web standards, so that data can be provided in different
formats from different users and still be accessible to all.
- Agree upon a method to authenticate the identities of doctors,
pharmacists, other health professionals, and patients using the web
site, so that they can quickly and securely access private health
information needed for their ongoing treatment.
- Make electronic health information records accessible to nurse
practitioners, physician assistants, and nurses who will likely be
working with physicians and clinics in a disaster's aftermath, rather
than just by physicians.
- Examine federal and state public policies governing privacy and
medical records — such as the Health Insurance Portability and
Accountability Act of 1996 and existing state privacy laws — to be sure
they do not hinder the delivery of medical care for displaced persons
"It is also critical that we educate people to take responsibility
for having up-to-date information on their prescription drug history,"
said Michael D. Maves, MD, chief executive officer and executive vice
president of the American Medical Association. "Everyone should make
sure they have this information, but it is especially critical for
people with chronic and life- threatening conditions."
KatrinaHealth.org provided authorized users with access to the
medication history of evacuees who lived in the areas affected by
Hurricane Katrina, with data or prescription information made available
from a variety of government and commercial sources. Sources included
electronic databases from community pharmacies, government health
insurance programs such as Medicaid, private insurers, and pharmacy
benefits managers in the states most affected by the storm.
than three weeks after Hurricane Katrina hit the Gulf Coast, this
information network was up and running," said Carol Diamond, MD, MPH,
managing director of the Markle Foundation and the leader of the
organization's KatrinaHealth efforts. "For many Americans, however, even a
few days without much-needed, life-saving prescription medications is too
"The nation's pharmacies and partners across the health care
industry believe that we must take the outstanding work done by the
KatrinaHealth initiative to the next level," said Kevin Hutchinson,
president and chief executive officer of SureScripts. "Rest assured, the
nation's pharmacies are applying the lessons learned to ensure that a
response is faster and more complete for patients this hurricane season and
beyond. Work is well underway, but there is more to do."
"It is estimated
that nearly 40% of Katrina evacuees were taking prescription medications
before the storm hit," said J. P. Little, chief operating officer of RxHub.
"This web site was particularly important because neither the evacuees nor
their health care providers had access to their paper medical records, many
of which were destroyed by the hurricane or left behind when evacuees fled
their homes for safer inland locations."
Several organizations, including the American Medical Association,
Informed Decisions LLC, Markle Foundation, SureScripts, and the United
States Department of Veterans Affairs, are being recognized today for
their leadership of the KatrinaHealth program with a 2006 Pinnacle Award
presented by the American Pharmacists Association Foundation (APhA).
This is the ninth year for the Pinnacle Awards, which APhA established
to celebrate significant contributions to the medication use process.
More than 150 organizations participated in the planning, testing,
launching, and facilitation of KatrinaHealth.org, including the American
Medical Association, Gold Standard, the Louisiana and Mississippi
Departments of Health, RxHub, the Office of the National Coordinator for
Health Information Technology within the U.S. Department of Health and
Human Services, SureScripts, and United States Department of Veterans
For a full copy of the Lessons from KatrinaHealth report, log onto