Medicaid contractor builds electronic drug record on the fly

The Health and Human Services Department began providing electronic drug data on Katrina evacuees to doctors working in shelters last week.

HHS is working with nine federal agencies, physicians and hospitals, retail pharmacists, insurers and the health departments of the three affected states to recover medical data and get it in one place so that physicians have access to it.

“This is a one-time effort to get data to support evacuees and doctors in the short term. There is no plan,” said David Brailer, HHS’ national health IT coordinator, after a presentation at the U.S. Chamber of Commerce in Washington. The federal government’s role was to lead the discussion about how public and private parties could collaborate. An electronic drug list is the only data so far to become available.

“What was done was in a way radical and in a way simple,” Brailer said.

The companies voluntarily worked together to create a site where shelter doctors could link to databases from a single source. Otherwise, doctors would have had to cobble together patient information from five sources. The databases contained prescription data for 80 percent of those affected by the storm and floodwaters, he said. The Veterans Affairs Department also contributed data.

Gold Standard Multimedia of Tampa, Fla., the Medicaid prescription-drug contractor for the three affected states, provided the front end, or gateway, so physicians could perform searches for patient information located in a variety of databases. The Medicaid contractor worked in collaboration with SureScripts of Alexandria, Va., a network provider of electronic prescribing services, and RxHub of St. Paul, Minn., which enables connectivity and medication data exchange between pharmacy benefit providers and caregivers.

Under HHS sponsorship, the companies created databases for 80 percent of those affected by Katrina and its aftermath. HHS is not paying the companies; their work is voluntary, Brailer said.

“This is [the health IT] equivalent to making donations and helping people with software,” he said.

The companies have business associate agreements to comply with Health Insurance Portability and Accountability Act (HIPAA) data privacy and security provisions. Those agreements are an enforcement statement that the companies are working together and have made verbal representations to conform with HIPAA until they can generate the formal paperwork.

“But there was no change in the law or requirements,” Brailer added.

Although the electronic drug list is only to support doctors in the field treating evacuees, “it has also shown everyone what you can do quickly if you can just get together,” he said. HHS is considering initiatives around digital recovery of the health information infrastructure of the Gulf Coast, but it’s not an extension of the emergency data re-creation for shelter doctors, he said.

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