AAFP Invites Health Information Technology Industry to Join National HIT Campaign in Response to Need for Standard, Portable, Electronic Health Records Before, During and After Disasters

LEAWOOD, Kan. -- In the wake of Hurricane Katrina, the American Academy of Family Physicians (AAFP) is calling on the health information technology (HIT) industry to support the need for all Americans and health care providers to have access to summary health information during times of crisis, using the Continuity of Care Record (CCR). The AAFP has established “Project Continuity of Care,” to recruit doctors, HIT firms, and agencies of the federal government toward the goal of making standardized health records available both in electronic and paper formats before, during, and after situations like the one being experienced in the aftermath of Hurricane Katrina.

“We have received many reports from family physicians as far away as Massachusetts and California who are hampered in their efforts to provide high quality care for Katrina victims because they do not have the patients’ medical histories and medication lists. This lack of access to key personal health information is both a hazard to patients and an impediment to the ability of physicians and other health care providers to deliver good quality, effective, and safe medical care,” said Mary E. Frank, M.D., AAFP’s president.

Family physicians, nurses, rescue workers, and many other health care professionals have had to treat thousands of people in shelters and refugee clinics without the benefit of even minimal health information about these patients’ current and past care, much of which has been lost or destroyed in the devastation. Universal adoption of a standard electronic “Continuity of Care Record” will help ensure better-informed health care decisions and medical procedures in future emergencies.

“There is no reason to wait. Fragmentation or total loss of patient health information at a time of crisis is completely unnecessary and unacceptable,” Douglas E. Henley, M.D., executive vice president of the AAFP said today when announcing Project Continuity of Care. “We now have affordable, standards-based technologies for capturing a patient’s most relevant health information and making it personal, private, and portable. Our aim with Project Continuity of Care is to provide physicians and other caregivers with access to this summary medical information when and where it is needed, and to give patients the assurance they deserve that they won’t suffer in an emergency because of lack of information about their personal illnesses or treatment plans.”

Project Continuity of Care has three major components. The first is to raise awareness about the availability of the new CCR standard for recording personal health summary information in an electronic file that can be handled in multiple ways, including in a computer database, on a USB drive that can be carried by patients in their pockets or purse, printed to paper as a pdf or Word document, or even stored in a cell phone. Once created, the patient’s CCR can then be viewed using any common Web browser software -- such as Internet Explorer or Firefox -- or uploaded into a computerized medical record program if one is available in a field station, a doctor’s office, emergency room, or hospital. The CCR is an American National Standards Institute accredited standard whose co-sponsors include the AAFP, American Academy of Pediatrics, American Medical Association, and the Patient Safety Institute, among many others. The CCR is both a formatting and message content standard, and has been developed in extensible markup language, or XML, to make it compatible with the full range of Internet standards.

The second component of Project Continuity of Care consists of the rapid development and deployment of software applications and tools to assist patients, physicians, and other health care providers to easily enter the summary health information necessary to create the CCR. “The information contained in the CCR, such as patient demographics, problem and diagnosis list, allergies and alerts, and medication list, does not require sophisticated or expensive software programs to be entered and put to good use in the field or for follow-up care,” said David C. Kibbe, M.D., director of the AAFP’s Center for Health Information Technology. “There are already early-stage software programs available that can be used by triage nurses and physicians to capture a patient’s most important personal health information to create a CCR, using laptop computers or hand-held devices, even in situations where there is no electricity or connection to the Internet. The CCR file can then be stored and transferred forward to the next provider as the patients’ needs require. The real value of the CCR as a standard is that it allows the information to be ‘entered once, used many times’ because common and available tools like Web browsers can read and interpret the information in it.” The AAFP will work with vendors and other federal and private-sector organizations to make these new tools widely available.

The third component of Project Continuity of Care is also already under way. The AAFP has been working with over thirty vendors of electronic health record software (EHRs) to accelerate the integration of the CCR standard into these popular software programs used in doctors’ offices, clinics, and hospitals to manage patient clinical information. The companies have coordinated their efforts and developed standard operating rules for CCR file export from, and import into, their products, greatly increasing the interoperability of these programs. “The more widespread the use of these EHRs is among medical practices, the easier it will be for patients to receive their summary health information in CCR format from their doctors before a crisis occurs,” said Dr. Frank. The CCR will make the follow up care better for both patients and physicians by providing that vital link between current and previous care and treatment decisions, which is what continuity of care is all about.” The AAFP will invite additional HIT firms to join in Project Continuity of Care, and look for more opportunities to encourage the widespread use of the CCR and integration into products and services. For information about Project Continuity of Care, please visit http://www.centerforhit.org/projectcontinuity.xml.