After The Storm

When Hurricane Katrina hit the Gulf Coast, apart from the human cost, it highlighted the need for electronic medical records. DCLnews reports.

After Hurricane Katrina hit the Gulf Coast in August this year, around a million people displaced by the storm were left high and dry when their paper medical records were destroyed by the floods. This made it virtually impossible for doctors to treat those in need of medical help.

"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 said.

"I saw physicians treating patients who were obviously ill and who were without sufficient information to make diagnoses."

Lucky break

Patients of The New Orleans Veterans Administration (VA) Medical Center, however, were among the lucky ones - they weren't reliant on paper medical records; they had electronic medical records (EHRs). The facility was completely flooded when Katrina hit. Despite this, around 50,000 EHRs survived completely intact thanks to the foresight of one man.

When Charlie Gephart, the Center's computer specialist, was airlifted to safety three days after Katrina, he was carrying back-up tapes of all the patient's EHRs. By the following evening, the EHRs had been re-entered into computers in Houston. Gephart said “Every single thing on that computer was saved.”

But while the EHRs saved the day the above story also brings home the importance of backing up EHRs elsewhere. If Charlie Gephart hadn't reached safety the records wouldn't have survived. Experts say it is vital healthcare facilities make sure they back up their records to another computer server and ensure that these tape back-ups are stored at secure location for retrieval in event of an emergency.

Speed up

The recent hurricanes in the US have certainly highlighted the need to speed up the adoption of EHRs. EHRs carry several advantages over paper, explains Michael Gorczynski, director of medical informatics at Aurora Healthcare in Milwaukee. "Clearly, the capability of electronic systems to not be ruined by whatever the disaster might be are much, much better than paper," he says. "Paper is a very fragile medium that can be blown away, washed away, blown up or contaminated with biological agents."

This point has also be taken up by Wisconsin Governor, Jim Doyle. He requested a $10 million grant for setting up a board to oversee and subsidize the development of EHRs as part of his "Grow Wisconsin Initiative". The request, however, was defeated at a Joint Finance Committee meeting. According to committee member Scott Jensen, this was down to the fact that the private sector is moving towards EHRs by itself making state subsidies unnecessary. "Why throw taxpayer dollars at it." he said

Nevertheless EHRs remain high on the agenda in Wisconsin. "When you look at Katrina and medical records, if they had had EHRs, they would not have been lost," said Stephanie Marquis, a spokesperson for the Wisconsin Department of Health and Family Services. "They're definitely more secure, and that sort of network can definitely improve patient quality and safety."

Legislation

One thing that is moving healthcare facilities towards digitization is the Patient Safety and Quality Improvement Act, which President Bush signed this summer. While the act is intended to improve patient safety and the quality of healthcare, it is also expected to increase the digitalization of healthcare records.

For one doctor in Milwaukee the change cannot come soon enough.

"What Katrina is doing, is it once again shows this dependency on paper records to be absolutely foolhardy for a nation as great as ours," said state representative, Sheldon Wasserman MD. He pointed out the need for EHRs saying: "We're living in an information age, and it's critical the government promote this."

Standards

Despite the obvious benefits from the use of EHRs, including fewer deaths from medical errors, the US government says more work needs to be done to create standards for electronic health records and other health IT initiatives before they can be implemented across the board.

The government still faces an "enormous challenge" in getting electronic health records to patients, David Powner, director of IT management issues for the Government Accountability Office recently told the House Committee on Government Reform.

George Bush called for the health care industry to embrace electronic health records, with the records available to all U.S. residents by 2014.

DCLnews editorial