Database helps get meds to evacuees

Washington -- In an unprecedented move, the federal government recently approved the launch of a Web site allowing access to prescription drug records for hundreds of thousands of Hurricane Katrina evacuees.

The site (link) allows all licensed pharmacists and physicians treating evacuees to find out what medications their patients have been taking; information about allergies and potential drug interactions is also included.

The Markle Foundation, one of the organizations that helped launch the effort, estimated that nearly 40% of those who fled the disaster were taking prescription drugs before the hurricane struck and would likely need to continue or enhance their treatments.

The new tool will be helpful for ensuring the continuing health of evacuees, many of whom will have trouble recounting their complete drug regimens for doctors whom they have never met before, said David Brailer, MD, PhD, the national health information technology coordinator.

"This showed us an urgent need where health information can play a role -- where among all the other aspects of both the disaster and the recovery, health information has a place that can mean a real difference in people's lives," he said. The storm "manifested itself in people coming to shelters without prescriptions, or physicians and clinicians there not knowing what medications they were taking [after] the destruction of medical records throughout the affected areas from the hurricane."

The American Medical Association is playing an integral role in the initiative by serving as the physician gatekeeper to the information. A doctor cannot receive a username and password to access drug records until the AMA confirms his or her identity using the Association's Physician Masterfile.

After receiving approval, physicians may use identifying information from Katrina evacuees to bring up data showing what drugs the patients have been taking and whether they need immediate refills.

The Web site culls necessary electronic information from a number of sources, including commercial pharmacies, government health programs, insurers and pharmaceutical benefit managers.

Doctors who are seeing patients from Louisiana will find the Web site invaluable for prescribing necessary medications for these new patients, said Fred Cerise, MD, secretary of the state's Dept. of Health and Hospitals.

"I got credentialed today through the AMA's Web site. It's very easy to do," he said in a recent conference call with reporters. "I sampled the system; it's very easy to navigate. You can get quick medication history on individuals through the process."

While the new site is not providing any information that cannot be obtained from an original source, the one-stop data clearinghouse will provide the speed that doctors need, said AMA President J. Edward Hill, MD. Dr. Hill volunteered in a makeshift clinic in Tupelo, Miss., in the days following the hurricane's strike.

"I saw firsthand the need to quickly identify the medications that these patients were taking," he said. "And that need has only intensified as these evacuees have spread across the country, far from their homes and their regular doctors and without any medical records at all."

A temporary effort

The initiative brought the Markle Foundation, a technology advancement group, into partnership with the AMA and such health information firms as SureScripts, Gold Standard and RxHub LLC to deliver the information. The short time it took participating organizations to get the new system up and running could hold lessons for the U.S. strategy for making health care information digital on a national scale, the groups said.

But physicians shouldn't expect the Web site or anything like it to become a permanent fixture in the health care system, Dr. Brailer said.

"This effort is one that we focused on because it was ... low-hanging fruit with very high value in a short-term emergency," he said. "This was not intended to be a long-term project. This was not intended to be a mechanism that would go forward."

Architects of the plan described it as a quick operation designed to provide only the bare essentials to respond to an urgent situation. Confidential health data that were not related to prescription drug utilization were redacted to safeguard privacy. Information about drug regimens for behavioral health, HIV/AIDS and chemical dependency was also removed from the final product.

Dr. Brailer's office will conduct an "after-action report" once the Web site has finished serving its purpose to see if any of its elements could apply to more permanent IT applications. But he stressed the limited utility of sharing only prescription information, which is already in a relatively standardized form.

At the very least, however, the Katrina drug project may start getting some doctors comfortable with the idea of using interoperable health care information, Dr. Hill said.

"Maybe the silver lining in this is that there will be many physicians who might have been reluctant or even skeptical relative to the [health IT] movement [who] will see its value in a much better way," he said.