Information technology  

Securing access to patient records in times of disaster — learning from Katrina

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 an 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 post-disaster.

"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." 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.

"In less 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 long."

"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, 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 Affairs.

For a full copy of the Lessons from KatrinaHealth report, log onto

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