AAFP Plays Role in New Orleans Health Recovery Week

The lure of free medical care, dental work, eyeglasses, pharmacy services and, yes, even a portable personal health record -- known as a PHR -- drew more than 3,900 people from hurricane-ravaged New Orleans and surrounding areas to the New Orleans Audubon Zoo from Feb. 6 to 12.

The New Orleans Health Recovery Week was spearheaded by the City of New Orleans Health Department and was billed as an opportunity to provide medical services to citizens and, in the process, regenerate lost or destroyed patient medical records in an electronic format. AAFP's Center for Health Information Technology, or CHiT, was instrumental in bringing together the computer systems necessary to ensure that patients' health records could be recorded electronically.

An army of volunteers from several states, including Virginia, Florida, Michigan, Colorado and Texas, assembled at the city's Audubon Zoo on Feb. 5, erecting tents, unloading supplies and setting up computer systems. Many of the physicians, dentists and support staff members were volunteers from Remote Area Medical® Volunteer Corps -- a nonprofit volunteer medical relief organization based in Knoxville, Tenn.

The health fair, which was already in its planning stages late last fall, got a boost in December when Morehouse School of Medicine in Atlanta joined the effort with a multimillion dollar grant from HHS' Office of Minority Health. The grant money is earmarked to help rebuild the Gulf Coast health systems that were damaged during Hurricane Katrina.

When AAFP member Dominic Mack, M.D., associate director for clinical affairs at the National Center for Primary Care at Morehouse, saw that electronic health records were one of five components of the grant, he asked David C. Kibbe, M.D., director of AAFP's Center for Health Information Technology, to serve as a consultant for the health fair. In turn, Kibbe pulled in two health information technology companies, Intel® of Santa Clara, Calif., and Solventus™ of Pompano Beach, Fla. Intel provided technical assistance, hardware and network infrastructure at the health fair. Solventus provided software to create health information files.

"This is the first time CHiT, Intel and Solventus have teamed up to implement a standardized, portable, interoperable PHR for a group of individuals," said Kibbe. "It's also the first time that the CCR (continuity of care) standard has been utilized in a public health project since its publication by ASTM in January 2006."

On the first day of the event, people start lining up outside the zoo entrance at 5:30 a.m. By 9 a.m., the line snaked through the parking lot to Magazine Street -- a distance of more than a city block -- and by 10 a.m., organizers had to close the line to newcomers.

By 3 p.m., however, it was clear that the process wasn't going to be flawless. Glitches hampered efforts to produce portable personal health records. Thousands of universal serial bus (USB) drives, which organizers planned to use to record PHRs, were in transit from the West Coast and didn't show up until it was too late for them to be used. Organizers decided to substitute compact discs for the drives, but the CDs were not used initially because of time constraints encountered while inputting patient information at registration and triage.

With hundreds of people waiting, volunteers resorted to keying in basic information and moving patients along with paper printouts. At the end of the first day, only a handful of patients walked away with their electronic medical records in hand. The situation improved as the week went on, however, and by Friday, all patients were able to walk away from the health fair with their personal health information on a CD.

Even with the problems, folks on the health information technology end of the fair called day one a success. "Even if this phase of providing USB drives with personal records doesn't work out here, there's still a viable solution up the line … the opportunity is not lost," said Tom Eberle, M.D., senior clinical architect at Intel. If the city maintains a database of what went on here today, "personal health records can be made available after the fact," he said.

Kibbe praised the collaboration between the Academy, the health IT companies and the New Orleans Health Department. "New Orleans officials understand the importance of EHRs, and they want to see it happen," said Kibbe. "Today, we made a start."

Mack envisioned in the not-so-distant future a databank built from the information collected that ultimately would provide a Web portal allowing patients to access their medical records from anywhere in the world. "We want things in place in case there's another disaster," said Mack, "so that when people evacuate … they'll still have access to their physician and their medical records."

As of the end of the day Friday, health fair volunteers had logged more than 3,900 patient registrations, according to Solventus. More than 16,000 services were provided, based on RAM volunteers' figures. They had provided more than 1,000 eye tests and given out more than 800 pairs of eyeglasses. Volunteers also performed 132 mammograms, nearly 1,600 tooth extractions, and more than 2,000 dental fillings.