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Personal Derived Health Information: A Foundation to Preparing the United States for Disasters and Public Health Emergencies

Published online by Cambridge University Press:  08 April 2013

Abstract

Background: In the days following a disaster/public health emergency, there is great effort to ensure that everyone receives appropriate care and lives are saved. However, evacuees following a disaster/public health emergency often lack access to personal health information that is vital to receive or maintain quality care. Delayed treatment and interruptions of medication regimens often contribute to excess morbidity and mortality following a disaster/public health emergency. This study sought to define a set of minimum health information elements that can be maintained in a personal health record (PHR) and given to first responders/receivers within the first 96 hours of a disaster/public health response to improve clinical health outcomes.

Methods: A mixed methods approach of qualitative and quantitative data gathering and analyses was completed. Expert panel members (n = 116) and existing health information elements were sampled for this study; 55% (n = 64) of expert panel members had clinical credentials and determined the health information. From an initial set of six sources, a step-wise process using a Likert scale survey and thematic data analyses, including interrater reliability and validity checks, produced a set of minimum health information elements.

Results: The results identified 30 essential elements from 676 existing health information elements, a reduction of approximately 95%. The elements were grouped into seven domains: identification, emergency contact, health care contact, health profile –past medical history, medication, major allergies/diet restrictions, and family information.

Conclusions: Leading experts in clinical disaster preparedness identified a set of minimum health information elements that first responders/receivers must have to ensure appropriate and timely care. If this set of elements is used as the fundamental information for a PHR, and automatically updated and validated during clinical encounters and medication changes, it is conceivable that following large-scale disasters clinical outcomes may be improved and more lives may be saved.

(Disaster Med Public Health Preparedness. 2012;6:303-310)

Type
Concepts in Disaster Medicine
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2010

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References

REFERENCES

1.Kessler, RCHurricane Katrina Community Advisory Group. Hurricane Katrina's impact on the care of survivors with chronic medical conditions. J Gen Intern Med. 2007;22 (9):12251230.Google Scholar
2.Stephens, KU SrGrew, DChin, K, et alExcess mortality in the aftermath of Hurricane Katrina: a preliminary report. Disaster Med Public Health Prep. 2007;1 (1):1520.Google Scholar
3.Subbarao, IBurkle, FLyznicki, J.The 5th Anniversary of Hurricane Katrina: legacy of challenges. Disaster Med Public Health Prep. 2010;4 (1):S10S11.Google Scholar
4.Centers for Disease Control and Prevention. Illness Surveillance and Rapid Needs Assessment Among Hurricane Katrina Evacuees, Colorado, September 1-23, 2005. MMWR Morbid Mortal Wkly Rep.March 10, 2006; 244-247.Google Scholar
5.The Patient Protection and Affordable Care Act, P.L. 111-148, 23 March 2010. .Google Scholar
6.Juffermans, JBierens, JLM.Recurrent Medical Response Problems during Five Recent Disasters in the Netherlands 2010, Prehospital and Disaster Medicine. http://pdm.medicine.wisc.edu/Volume_25/issue_2/juffermans.pdf. Accessed April 10, 2010.Google Scholar
7.Madamala, KCampbell, CRHsu, EBHsieh, YHJames, J.Characteristics of physician relocation following Hurricane Katrina. Disaster Med Public Health Prep. 2007;1 (1):2126.Google Scholar
8.Tang, PCAsh, JSBates, DWOverhage, JMSands, DZ.Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption. J Am Med Inform Assoc. 2006;13 (2):121126.CrossRefGoogle ScholarPubMed
9.Creswell, JWClark, VL.Designing and Conducting Mixed Methods Research.Thousand Oaks, California: Sage Publication; 2007.Google Scholar
10.Boyatzis, R.Analysis and Code Development: Translating Qualitative Information.Thousand Oaks, California: Sage Publications; 1998.Google Scholar
11.45 CFR Part 170; RIN 0991-AB82; Proposed rule.Department of Health and Human Services, Office of the Secretary, Office of the National Coordinator for Health Information Technology (ONC), Centers for Medicare & Medicaid Services (CMS,) Stage 2 Meaningful Use Proposed Rule.Google Scholar
12.Neumann, CMForman, DLRothlein, JE.Hazard screening of chemical releases and environmental equity analysis of populations proximate to toxic release inventory facilities in Oregon. Environ Health Perspect. 1998;106 (4):217226.Google Scholar
13.Burke, J.Addressing Special Populations Through the Public Health Incident Command System.Washington, DC: American Public Health Association; November 2011.Google Scholar
14.Greenough, PGLappi, MDHsu, EB, et alBurden of disease and health status among Hurricane Katrina-displaced persons in shelters: a population-based cluster sample. Ann Emerg Med. 2008;51 (4):426432.Google Scholar
15.Houston, TKSands, DZJenckes, MWFord, DE.Experiences of patients who were early adopters of electronic communication with their physician: satisfaction, benefits, and concerns. Am J Manag Care. 2004;10 (9):601608.Google Scholar
16.Agency for Healthcare Research and Quality. Recommendations for a National Mass Patient and Evacuee Movement, Regulating, and Tracking System.Rockville, Maryland: Agency for Healthcare Research and Quality; January 2009.Google Scholar
17.Health and Human Service Statement of Initiatives. http://www.hhs.gov/ash/initiatives/index.html Accessed November 8, 2011.Google Scholar