Sunday, June 29, 2014

Need for Electronic Health Record as Response to Tragic Hurricane Katrina

For a person who was born in a tropical country and grew up experiencing some 20 typhoons a year (Haiyan, Washi and Ketsana are some of the destructive to have hit Asia), not to mention writing tragic stories while delivering relief goods to far flung areas when I was as a reporter for a daily newspaper, Katrina to me was a very upsetting event because America was supposed to easily cope with such a crisis.  Besides, isn’t the US of A that’s been helping the Philippines and other calamity-stricken countries in times like this?  

The days beginning August 29, 2005 could be one of America's worst, if not the worst, chapters in its modern history on natural disasters, not only because the deluge was unheard of but because of the racially-charged politics involved, personal hygiene of unimaginable proportions (because it happened in the US) and the time that it took the Bush administration to provide help to those affected.  And who could be far worse victims than the impoverished people of New Orleans, who could barely afford to live decently before and when Katrina hit. In an article entitled "Health Care In New Orleans Before And After Hurricane Katrina" published by the Maryland-based Health Affairs, it said that when the hurricane came “New Orleans had a largely poor and African American population with one of the nation’s highest uninsurance rates, and many relied on the Charity Hospital system for care” (Robin Rudowitz, 2014)

Which brings to mind the very divisive issue of a government-run program like Obamacare to provide quality healthcare to everyone as opposed to letting private companies run the industry…as should be in a capitalist society.  But when it comes to US veterans or if it concerns those who are serving the country, hardly is there an argument on the full use of government resources. Providentially, the Hurricane Katrina tragedy may have proven that a nationally-coordinated plan – whether its healthcare or disaster response – works in a very efficient way. 

Despite Floods, Veterans Electronic Record Basically Intact

The floods that inundated New Orleans, other cities and neighboring states spared no one; homes and properties were submerged for days.  As discussed before, a lot of paper medical records were destroyed.  In today’s homework,  however, the “complete electronic clinical records” of US service veterans were immediately accessible. These were made possible by a rehosted VistA system and by the Consolidated Mail-Out Pharmacy – an automated prescription fulfillment system that processes outpatient prescriptions – although the latter was interrupted by the hurricane it remained online and was accessible. In fact, two weeks after the hurricane slammed the southern coast, “all of (veteran) patient data (from the affected states) was available nationwide within 7 hours (American Public Health Association, 2007).” Contrast this with the “non-VA evacuees” 200,000 of whom from the 1.3 million residents of New Orleans who had “chronic conditions needing ongoing management” but who in their “rush to evacuate, many left home without documents, medications, and other essentials (APHA: Katrina Evacuation, 2007)” Thus, in an article by Public Health Association, it said that “Responding clinicians were challenged with assessing unfamiliar and ill evacuees without the benefit of their medical charts (APHA: Katrina Evacuation, 2007).” Worse, it added, the consequences may still be affecting thousands of others but these could not be understandably monitored as people without records have spread to different places, meaning there were no succeeding statistics as to their current health status.  The article SUMMED UP the “stark contrast”: VA efforts to maintain appropriate and uninterrupted care were supported by nationwide  access to comprehensive electronic health records systems” as opposed to those who did not – who are the majority and were poor. (APHA: Katrina Evacuation, 2007).

Other facts:
After a month, or by the end of September, 2005, VA producers had accessed clinical data for 38%  of New Orleans VA patients;
Healthcare data were delivered to more than 2,300 users at more than 200 VA sites in 48 states and District of Columbia;
Before Katrina, New Orleans veterans had more than 75,000 prescriptions filled – right after Katrina, more than half or about 41,000 had their prescriptions immediately filled through a rehosted system;
Between August 29 and September 30, VistAWeb, a patient index and locator for veterans, logged 59,454 requests for Web pages containing clinical, etc. (VistAWeb, 2007).

Katrina Exposed Advantages and Need for Electronic Medical Record

Going back to my point, since Obamacare which provides for the “electronication” – for lack of a better word – of medical records, politics seem to be out-of-line when a national program for US servicemen and veterans are concerned.  While Republicans ironically oppose a national healthcare program, they are more than willing to extend assistance to the veterans, which as was shown in the Katrina experience, in a system whereby clinicians can access medical data of patients that turned out to be very much beneficial.  In an earlier class discussion on this topic, Katrina-affected children whose vaccination records were submitted to a nationalized system also proved its worth and is cost-effective, efficient, accurate, verifiable and obviously accessible.  In the case of veterans, who because of their age and injuries suffered from serving the country, accessibility to this important medical data was paramount or else their health conditions might have been largely compromised.  We all know that in disasters and tragedies such as the Hurricane Katrina event, as in any medical emergency, time is of the essence.  Not only are medical records important as to the health status of a person, especially a victim, they are now a requirement in employment, background checks, prevention of communicable diseases or epidemics, and most importantly, in research since demographics are very useful for this purpose. 

Urologist Neil Baum, MD, an assistant clinical professor at Tulane University School of Medical in New Orleans who quoted by Foxnews.com in an interview with WebMD, has said that “If the displaced patients left with their records in an electronic format, there would have been better continuity of care and fewer mistakes would be made.” After the storm, Baum who temporarily relocated to Austin, Texas, said he was able to treat his displaced, patients and “had access to some of my patients’ records over the Internet and that made communicating much easier.  I was able to get lab reports, X-rays and pathology reports and it made coordinating care in the patients’ new cities much easier.” Baum thus declared that “I am convinced now more than ever that patients should have portable access to medical records. (Mann, 2005)

A free enterprise is ideal and a market economy spurs development that create jobs.  However, just like the national defense, some sectors need to be nationalized like the healthcare system, in my opinion, for safety and security of all Americans, and for a quicker response in order to save one’s life.  In today’s world, where doctors can now diagnose a person halfway around the world through a smartphone or a tablet, it would be an irony if a child or an elderly in places like Katrina-affected areas will be left suffering, if not dying, because their medical record was lost to the flood. 

Bibliography

American Public Health Association. (2007, April). Use of Electronic Health Records in Disaster Response: The Experience of Department of. American Journal of Public Health , 6.

APHA: Katrina Evacuation. (2007). KATRINA AND THE EVACUATION OF NEW ORLEANS. American Journal of Public Health , 3.

Mann, D. (2005, September 23). Katrina Shows Need for Electronic Health Records, Online. (Fox News) Retrieved April 9, 2014, from www.foxnews.com: http://www.foxnews.com/story/2005/09/23/katrina-shows-need-for-electronic-health-records/

Robin Rudowitz, D. R. (2014). Health Care In New Orleans Before And After Hurricane Katrina.

VistAWeb. (2007, April). Use of Electronic Health Records in Disaster Response: The Experience of Department of. American Journal of Public Health , 4.

American Public Health Association. (2007, April). Use of Electronic Health Records in Disaster Response: The Experience of Department of. American Journal of Public Health , 6.
APHA: Katrina Evacuation. (2007). KATRINA AND THE EVACUATION OF NEW ORLEANS. American Journal of Public Health , 3.
Mann, D. (2005, September 23). Katrina Shows Need for Electronic Health Records, Online. (Fox News) Retrieved April 9, 2014, from www.foxnews.com: http://www.foxnews.com/story/2005/09/23/katrina-shows-need-for-electronic-health-records/
Robin Rudowitz, D. R. (2014). Health Care In New Orleans Before And After Hurricane Katrina.

VistAWeb. (2007, April). Use of Electronic Health Records in Disaster Response: The Experience of Department of. American Journal of Public Health , 4.

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