1. What is www.KatrinaHealth.org?
   KatrinaHealth.org is a secure, online service giving authorized healthcare providers access to medication and dosage information for evacuees from Hurricane Katrina. The site will allow authorized physicians and pharmacies to renew critical medications, coordinate care, and avoid potential medication errors, when renewing or prescribing new medications. KatrinaHealth.org was established through the efforts of medical software companies; pharmacy benefit managers; chain pharmacies; local, state, and federal agencies; and a national foundation.
   
   
2. Why is KatrinaHealth.org needed?
   Hundreds of thousands of residents of areas hit by Hurricane Katrina have been displaced from their homes and are living in shelters or temporary housing across the United States. Many of the evacuees were taking prescription medications before the storm hit, according to a Washington Post and Kaiser Family Foundation survey, and many more need new and additional medications now. Their paper medical records may have been destroyed during the storm, and their doctors may have been evacuated and relocated, making it impossible to obtain their personal prescription information. The healthcare providers and pharmacists currently caring for evacuees need access to accurate information about the medications that these individuals had been taking and the doses in which they had been prescribed. KatrinaHealth.org provides this information in one place.
   
   
3. What has been the impact of Hurricane Katrina on the population of the Gulf States and their health status?
   • According to the U.S. Census Bureau, an estimated 9.7 million people living in Alabama, Louisiana, and Mississippi experienced hurricane force winds as Hurricane Katrina crashed into the Gulf Coast.
   • According to new data from the Census Bureau's American Community Survey, about 2.1 million people in Alabama, Louisiana, and Mississippi lived below the poverty level.
   • Across the three states hardest hit by the storm, about 4.9 million people, or about 41% of the population, live in coastal areas.
   • About 3.2 million people live within the flood area - which encompasses southeast Louisiana (1.7 million), southern Mississippi (940,000), and southwest Alabama (420,000). Cities located along the Gulf that experienced flooding include Biloxi and Gulfport (Mississippi), Mobile (Alabama), and New Orleans (Louisiana).
   • Louisiana officials have said there were more than 1 million evacuees from that state alone, and Mississippi officials have said the total number of people displaced could be several hundred thousand.
   • These evacuees face continuing hardships as a result of their displacement, as well as a number of health-related challenges. A survey of evacuees in shelters in the Houston area between September 10 and 12, conducted by The Washington Post, the Kaiser Family Foundation, and the Harvard School of Public Health, found that:
     • 52% reported having no health insurance coverage at the time of the hurricane. Of those with coverage, 34% said it is through Medicaid and 16% through Medicare.
     • Before the hurricane, 66% of the people evacuated to Houston shelters used hospitals or clinics as their main source of care; of those, a majority (54%) used Charity Hospital of New Orleans, substantially more than the second most common care site (University Hospital of New Orleans, 8%).
     • 41% reported chronic health conditions such as heart disease, hypertension, diabetes, and asthma.
     • 43% said they are supposed to be taking prescription medications; of those, 29% percent reported having problems getting the prescription drugs they need.
   
   
4. Who has access to KatrinaHealth.org?
   To ensure patient confidentiality and security, KatrinaHealth.org will only be accessible to authorized health care providers and pharmacists who are providing treatment or supporting the provision of treatment to evacuees.
   
   
   • The American Medical Association (AMA) will be providing physician credentialing and authentification services and will validate the identity of health care providers. For information on how physicians can obtain login information, please contact the AMA's Unified Service Center at 1-800-262-3211.
   • The National Community Pharmacists Association (NCPA) will provide authentification and access for independent pharmacy owners. For information on how independent pharmacies can obtain login information, please contact the NCPA at 1-888-291-1131.
   • SureScripts will provide these services for chain pharmacies on behalf of the National Association of Chain Drug Stores (NACDS). For information on how chain pharmacies can obtain login information, a representative from a chain pharmacy headquarter location can contact the SureScripts Electronic Prescribing Resource Center at 1-866-797-3239.
     
     
5. Is the site secure?
   Yes, privacy and security were central to the design of KatrinaHealth.org. To ensure patient confidentiality and security, KatrinaHealth.org will only be accessible to authorized health care providers and pharmacists who are providing treatment or supporting the provision of treatment to evacuees. Tools are in place to prevent unauthorized access, and audit logs of who has access to the system and what records are being accessed will be rigorously maintained and reviewed.
   
   In addition, consistent with many state privacy laws, highly sensitive personal information was filtered.
   
   
6. Is the use of KatrinaHealth.org consistent with the HIPAA Privacy Rule (45 CFR Part 160 and Subparts A and E of Part 164)?
   Yes, using KatrinaHealth.org is consistent with HIPAA Privacy Rule (45 CFR Part 160 and Subparts A and E of Part 164). Please see www.hhs.gov/ocr/hipaa/EnforcementStatement.pdf for more information.
   
   
7. What sources were used for the data on individual prescriptions now found on KatrinaHealth.org?
   The information on KatrinaHealth.org has been made available from more than 150 private and public organizations' electronic databases from commercial pharmacies, government health insurance programs such as Medicaid, private insurers, and pharmacy benefits managers in the states affected by the storm.
   
   Key data and resources were contributed by the American Medical Association (AMA), Gold Standard, the Markle Foundation, RxHub and SureScripts.
   
   Data contributors also include:
   • The Medicaid programs of Louisiana and Mississippi
   • Chain pharmacies (Albertsons, CVS, Kmart, Rite Aid, Target, Walgreens, Wal-Mart, Winn Dixie)
   • Pharmacy Benefit Managers (RxHub)
   
   
8. Is there information on every Katrina evacuee on KatrinaHealth.org, and is the information on each evacuee complete?
   Some individuals who were taking prescription medicines may not be included at present in the data available through KatrinaHealth.org. However, the ability to access information about more patients will grow on a rolling basis. Moreover, while every effort has been made to make readily available as much electronic data as possible, the data available through KatrinaHealth.org does not necessarily contain all possible information about an individual's prescription history. It is recommended that you check KatrinaHealth.org often if you cannot initially locate your patient's prescription drug information through the site.
   
   Where ever possible, it is recommended that the information about individuals that is available through KatrinaHealth.org be reviewed by the patient themselves, and, when possible, their original health providers. If the data does not match the clinical presentation, it may be due to an error in the data. This data is made available from multiple sources; therefore, it may contain errors of omission or duplication. This information is intended to be used as supportive information to complement the physician's assessment of the clinical presentation.
   
   The sources of this information have made reasonable efforts to make available the data in a format that provides the user with a reference of medication histories for the defined population of Hurricane Katrina evacuees as of the date of the storm (e.g., "medication claims data"). No party makes any representation, express or implied, that the medication claims data is complete, comprehensive, or free of any errors. The data is being provided as a reference, to assist in providing care for the Hurricane Katrina evacuees.
   
   
9. Which government agencies, business, and organizations have participated in the creation of KatrinaHealth.org?
   The information on KatrinaHealth.org has been made available from more than 150 private and public organizations' electronic databases from commercial pharmacies, government health insurance programs such as Medicaid, private insurers, and pharmacy benefits managers in the states affected by the storm. The effort KatrinaHealth.org has been facilitated by the Office of the National Coordinator for Health Information Technology (ONC), U.S. Department of Health and Human Services, and key data and resources were contributed by the American Medical Association (AMA), Gold Standard, the Markle Foundation, RxHub and SureScripts.
   
   The following is a list of contributor and pilot site participants.
   
   Contributors and Particpants
   American Medical Association
   American College of Physicians
   American Health Information Management Association
   American Health Quality Association
   American Medical Group Association
   American Medical Informatics Association
   American Red Cross
   Association of American Medical Colleges
   Blue Cross and Blue Shield Association of America
   Blue Cross and Blue Shield of Louisiana
   Center for Health Transformation
   Computer Sciences Corporation
   eHealth Initiative
   Electronic Health Records Vendors Association
   Gold Standard
   Harvard School of Public Health
   Healthcare Information Management Systems Society
   Healthworks Louisiana
   Hospital Corporation of America
   Louisiana Healthcare Review, Inc.
   IBM
   International Rescue Committee
   Manatt, Phelps and Phillips
   Markle Foundation
   National Association of Chain Drug Stores
   National Community Pharmacists Association
   National Alliance for Health Information Technology (the Alliance)
   National Opinion Research Center
   Pharmaceutical Care Management Association
   Regenstrief Institute
   Robert Wood Johnson Foundation
   RxHub
   State of Louisiana, Department of Health
   State of Mississippi, Department of Health
   SureScripts
   Swandivedigital
   U.S. Department of Commerce
   U.S. Department of Defense
   U.S. Department of Health and Human Services
   • Office of the National Coordinator for Health IT
   • Centers for Disease Control (CDC)
   • Centers for Medicare and Medicaid Services (CMS)
   • National Institutes of Health (NIH)
   • Federal Drug Administration (FDA)
   • Agency for Healthcare and Research (AHRQ)
   U.S. Department of Homeland Security
   U.S. Department of Veterans Affairs
   Verizon
   
   Chain Pharmacies
   Albertsons
   CVS/Pharmacy
   Kmart
   Rite Aid
   Target
   Walgreens
   Wal-Mart
   Winn Dixie
   
   Pharmacy Benefit Managers
   Caremark
   Express Scripts
   Medco Health Solutions
   
   Pilot Site Participants
   Shelter staff at Reunion Arena and Dallas County Convention Center in Dallas, Texas
   Special Needs Shelters in Louisiana
   Sparks Regional Medical Center
   University of Mississippi Medical Center
   University of South Alabama College of Medicine
   University of Texas at Houston
   University of Texas Southwestern
   
   
10. How will prescriptions be paid for if an individual evacuee's insurance is unknown or non-existent?
    KatrinaHealth.org is a secure online service offering information about individuals' prescription drug use, and it does not offer financial support for those who do not have the means to pay for their own prescription medications. However, there are a number of sources for finding information about low-cost and free health care coverage options. To find out if children in your care are eligible for public health care coverage programs, please call 1-877-KIDS-NOW, which is managed by the U.S. Department of Health and Human Services. For others, please log on to www.covertheuninsuredweek.org and read "resources for individuals" in both English and Spanish. Resources on this site are listed for every state, and they may be of help.
    
    
11. How can consumers use KatrinaHealth.org?
    KatrinaHealth.org is intended for use by licensed doctors and pharmacists to search for information about evacuees' prescription drugs. This website will inform doctors and pharmacists which drugs a patient has been prescribed, his or her doses, whether refills are available and which doctor prescribed them. Any authorized doctor or pharmacist anywhere in the United States will be able to get information from KatrinaHealth.org.
    
    
12. How can physicians use KatrinaHealth.org?
    Authorized doctors will use KatrinaHealth.org as needed in support of providing medication services to evacuees. For details on how to access the site, please refer to www.KatrinaHealth.org and read the "For Doctors" section.
    
    
13. How can pharmacists use Katrina Health.org?
    Pharmacists will use KatrinaHealth.org as needed in support of providing medication services to evacuees. For details on how to access the site, please refer to www.KatrinaHealth.org and read the "For Pharmacists" section.
    
    
14. What steps have been taken to screen sensitive personal information?
    Privacy and security were central to the design of KatrinaHealth.org. Particular care was taken to ensure that only users authorized by the American Medical Association (AMA) or appropriate pharmacy organizations would gain access to the site. Consistent with many state privacy laws, KatrinaHealth.org filters out highly sensitive personal information.
    
    
15. Is the data on the site aggregated or is it dynamic or a mix?
    KatrinaHealth.org provides access to a mix of data sets. Some of the data from the chain pharmacies (Albertsons, CVS/Pharmacy, Kmart, Rite Aid, Target, Walgreens, Wal-Mart and Winn Dixie) has been aggregated and is static data representing dispensed drug history for any patient that has picked up a medication within the 90 days preceding the disaster. However, other available information resides in other locations and has not been aggregate. KatrinaHelath.org provides access to those data sets for authorized users, but it does not create a central database. Much of the data from insurance programs resides in other locations.
    
    
16. Why was KatrinaHealth.org not available during the initial aftermath of Hurricane Katrina?
    KatrinaHealth.org is a completely new, secure online service, created in just three weeks through a remarkable collaborative commitment by many organizations. While there are many organizations, businesses, foundations, elected officials, and government agencies that support the idea of nationwide health information exchange, there are few established, commonly used standards for storing and transmitting prescription information or any other kind of health information on a truly interoperable basis, and few established business and legal arrangements to make such sharing possible. Recent technical and policy work conducted by the Office of the National Coordination for Health Information Technology (ONC), the Connecting for Health Collaborative of the Markle Foundation and many collaborators, and other key players in the arena of connectivity in health care provided a foundation for the rapid progress we were able to make in response to the Katrina crisis. Still, the fact that KatrinaHealth.org was not available immediately underscores the need for open, common standards for health interoperability in the United States and reinforces the importance of current public and private activities to achieve the ability to exchange health information electronically.

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