October 1 2005

Physicians use existing or donated mobile technology to help treat people affected by Hurricane Katrina.

By Beckie Kelly Schuerenberg, Senior Editor, "Mobile Health Data" and "Health Data Management"

Hurricane Katrina forced hundreds of thousands of people to evacuate the Gulf Coast and fend for themselves, often far from home. Many of these refugees not only might have had their homes damaged or destroyed by the storm, but also their medical centers and medical records.

As they seek care in relief centers or hospitals in other areas of the country, evacuees have been hindered by lack of access to their medical records or clinicians familiar with their medical history. To help close the gaps, several mobile technology vendors have donated their products to help physicians caring for those
displaced by Hurricane Katrina.

For example, Boston-based PatientKeeper Inc. has donated several dozen licenses for its PatientKeeper Personal hand-held application to physicians treating people affected by the disaster. The software is a standalone application that enables physician PDA users to collect and share patient data. It's designed for
physicians whose health care organization doesn't offer wireless access to clinical systems.

The vendor doesn't have specific information about the physicians using the system in the relief effort.

Additionally, Motion Computing Inc., Austin, Texas, donated Tablet PCs to nurses and physicians working in a makeshift clinic in the Astrodome in Houston--a temporary refugee center--to gather patient information.

Clinicians volunteering in such refugee centers sometimes find themselves treating new types of conditions among the hurricane victims. Some are using I.T. to help.

Brandy Yates, R.N., for instance, is an emergency department nurse practitioner at East Alabama Medical Center, Opelika. In addition to her full-time job, Yates has been volunteering at a Red Cross relief center in Auburn that at one time housed 2,000 hurricane refugees.

Before beginning her volunteer work, she rounded up several medical reference books to the shelter so she could read up on medications and treatments for various nonemergency conditions that she doesn't normally see in her regular care. The list includes management of hypertension and diabetes.

Just before packing the last medical reference book into her car, she received an e-mail from Epocrates Inc. The company had renewed her hand-held medical reference software subscription free for the next three months to assist her in treating Hurricane Katrina refugees.

The San Mateo, Calif.-based vendor is offering free temporary access to its products to 25,000 caregivers treating evacuees in Florida, Louisiana, Alabama, and South Carolina, as part of the relief effort. Yates, who sees about 12 patients in a two-hour shift at the Auburn relief center, says the free access has helped
her because she doesn't have to drag her medical textbooks with her each time she volunteers.

"I had let my subscription expire about two months ago and didn't have time to download a new one before I started volunteering," she says. "I used the free subscription with the first person I saw at the center."

After the storm, some victims couldn't recall details about medications they were taking. Yates' first patient only remembered that she was taking a white pill and a pink pill for hypertension. So Yates used her PDA, from Palo Alto, Calif.-based Hewlett-Packard Co., to access the drug reference software from Epocrates to determine which exact medications the patient had been taking.

Several of Yates' colleagues also are using the temporary free subscriptions to help treat the evacuees.

Identifying bodies

Donated mobile technology also is being used to help identify people who perished as a result of Hurricane Katrina. Officials in Harrison and Lafayette counties (Miss.) are tagging body bags with radio frequency identification chips from VeriChip Corp., a subsidiary of Delray Beach, Fla.-based Applied Digital.

The chips contain a 16-digit identification number that can be read with the vendor's readers. Relief workers are entering the ID number into a public, Web-based "people locator" database set up by Harrison County and the Georgia Bureau of Investigation. Harrison County workers also are entering
personal information about the deceased, including where they were found and a list of what they had in their possession to help family members identify them.

VeriChip originally donated a mobile trailer clinic to the Mississippi Department of Health where patients could be treated or implanted or tagged with one of its chips as a way to start an electronic medical record for them, says Mark Poulshock, president of Thermolife Energy, also a subsidiary of Applied Digital. Poulshock helped coordinate the distribution and use of VeriChip supplies to disaster relief efforts.

VeriChip donated 560 chips and readers to Harrison County and the U.S. Disaster Mortuary Operational Response Team to be used to help identify bodies, he says.

The vendor's RFID chips also are being used to identify bodies that have become exposed from cemeteries that flooded in the hurricane, he says. Lafayette County officials plan to store some of the chips for body identification if needed for future disasters.

Attempts by Mobile Health Data to contact Harrison County Coroner Gary Hargrove, who is leading the DMORT efforts, were unsuccessful.

The disaster also has left caregivers with questions about their patients. Scott Needle, M.D., doesn't know which of his patients survived Hurricane Katrina, or which ones will be returning to his practice in Bay St. Louis, Miss.

He plans to return there and resume his pediatrics practice at the beginning of this month. The solo practitioner visited the area once since evacuating to find his office was flooded beyond repair during the hurricane.

However, Needle recovered the data in his entire electronic medical records system by saving the application on his Tablet PC before he evacuated. Needle saved his combined electronic records system and practice management system, from eClinicalWorks, Westborough, Mass., on his Travel Mate C110
Tablet PC, from Acer Inc., San Jose, Calif.

Needle has been mobile himself, staying with family in Maryland and friends in Birmingham, Ala. But his patients' parents tracked him down in search of information in their child's medical record, such as immunization records they need to enroll them in new schools. Needle has been able to access such data and send it to the parents, who now are scattered around the country.

"I'm lucky to still have access to my patients' medical records. Now I can be anywhere in the country and talk to my patients and have access to their records," he says. "I can't imagine if I was still using paper records. The files would have been lost or destroyed in the hurricane."

Needle, however, isn't sure how much of his practice's hardware he will salvage on returning to Bay St. Louis. A temporary solution awaits: The local hospital, Hancock Medical Center, has set up mobile trailers equipped with a broadband Internet connection for physicians to use if the building housing their practice
is unusable.

Needle plans to resume seeing his patients in the area soon and take in any patients of the city's other two pediatricians, who haven't yet returned. He also plans to add a wireless modem for his Tablet PC so he can download software updates from the records system vendor.