Tuesday, August 31, 2010
Excerpt from the WSJ August 31st 2010
http://topics.wsj.com/article/SB20001424052748703418004575456103886552286.html
It’s a simple step, but one many doctors forget to remind patients to take: Wear a medical-alert bracelet.
A growing number of American adults and children face complex medical conditions like heart disease and diabetes. They may have drug or food allergies, suffer from disorders like autism, or take medications like the blood thinner coumadin that medical staff should know about in an emergency.
New bracelets and other medical-identification systems can fill in first responders on practically a patient’s complete health history. They’re a far cry from the simple identification bracelets of the past, which with a few engraved words informed medics that a person was, perhaps, allergic to penicillin. They can steer first responders to a secure website or toll-free phone number, or initiate a text message, to get the medical and prescription history of a patient who may be unconscious or unable to talk about their condition.
Of course, wearing the traditional clunky metal medical-alert bracelets might be a turnoff to some, and too visible a reminder of a disease or condition. That’s one reason a number of jewelry companies make bracelets, necklaces and watches that look like real bling—Tiffany & Co. has a gold bracelet for $2,250, for instance—and some pendants can easily be hidden under clothes.
But unless these are linked with membership to a medical-information service, such as the nonprofit MedicAlert Foundation, emergency responders’ knowledge will be limited to what’s engraved on the accessory. People who don’t want to wear jewelry can carry a specially marked USB flash drive loaded with emergency data that medics can read from any computer in an emergency. Whatever identification system is chosen, doctors say, it should provide a way for responders to access as much information as possible quickly.
“Many patients have situations that are so much more complex than just the penicillin allergy that can be noted on a bracelet,” says Robert Pearl, chief executive of the Permanente Medical Group, part of nonprofit health system Kaiser Permanente. “We also have to look for drug-drug interactions, drug dosages, or compare an old EKG against a new one if you are having chest pains,” he says. Kaiser last year began offering members in Northern California a $5 flash drive loaded with personal information that can be regularly updated from Kaiser’s electronic medical-records system.
As the recipient of a bone-marrow transplant for leukemia 18 years ago and three related procedures since then, I recently learned the hard way that I should be wearing a medical-identification bracelet myself. One morning in May I ended up in the emergency room after an internal injury resulted in heavy blood loss. When I was told I was going to need a blood transfusion, fortunately I was alert enough that a red flag went up in my head.
People who have received a bone-marrow transplant, or are in treatment for blood cancers, typically need a form of blood treated with radiation to kill off certain white blood cells that can cause a potentially deadly reaction. My husband called one of my transplant doctors to confirm this, and the transfusion was able to be put off a few hours until irradiated blood, which isn’t always readily available, could be located.
During an annual checkup last month at Seattle’s Fred Hutchinson Cancer Research Center, where I received my original transplant, I informed my doctors about my emergency transfusion and they suggested wearing a bracelet in the future. Though transplant patients are told after discharge that they should receive only irradiated blood, the center is now formulating a policy to also advise them to wear a medical-alert bracelet.
Anyone with a medical condition that would not be obvious to medics or doctors if they were unable to communicate should consider some form of medical-identification program, says Alfred Sacchetti, a member of the American College of Emergency Physicians who worked with MedicAlert on guidelines for children’s emergencies. Dr. Sacchetti, an emergency physician at Our Lady of Lourdes Medical Center in Camden, N.J., says he often encounters children with complex medical conditions like endocrine disorders whose parents say they were never told their child should wear a bracelet.
Christie Iannucci, Dr. Sacchetti’s 28-year old daughter, has worn a MedicAlert bracelet that says “heart disease” since she was in fifth grade. Ms. Iannucci, a teacher in Medford, N.J., says in the event of an emergency, first responders need to know that her heart rate, which might not sound normal, is normal for her. To dress up the metal bracelet, she says she wears it with her grandmother’s diamond tennis bracelet.
Engraved on bracelets issued by MedicAlert are a patient’s member number and a toll-free number to access a 24/7 hot line for information. The service costs adults $39.95 for the first year and $30 annually after that; children’s fees are less. MedicAlert has added services like notifying family members in an emergency.
Ramesh Srinivasan, MedicAlert’s executive vice president, says the organization has seen a growing number of parents signing up kids with food allergies and autism spectrum disorders. There is also interest in bracelets that say “no known medical conditions” so treatment won’t be delayed in an emergency, as well as more demand from younger adults who are active athletes with medical issues, he says. Nearly half the group’s 2.3 million U.S. members are over 65.
Privacy is a concern to some people considering wearing a medical-alert bracelet. When Kaiser Permanente loads a patient’s data onto a flash drive, it encrypts the file and protects the contents with a password.
For people whose doctors don’t keep electronic medical records, companies like MedInfoChip sell software programs for about $50 that help consumers set up their own health records on a computer and load them onto a USB device. American Medical ID offers a flash drive in a dog-tag style pendant for $44.95 that can be engraved with basic medical information and loaded with a patient’s medical records.
Another program, called Invisible Bracelet, does away with the need to wear a bracelet or carry a device. The program, a partnership between Docvia LLC of Tulsa, Okla., and the American Ambulance Association, a trade association, allows members for $10 a year to upload personal medical data to a secure website and receive a personal identification number. Members get cards to place behind their driver’s license, key fobs and stickers that can be put on, say, a bike helmet that show their identification number and the website address.
The program is currently available in a dozen markets and is expected to expand. Docvia trains ambulance medics to use the system. The website also allows medics to automatically generate text or email messages to designated family members notifying them where the patient is being taken by ambulance.
Brandi O’Dell, a mother of three in Tulsa, says she signed up her husband for the Invisible Bracelet program after reading about it on a website. She says her husband, Kyle, has a rare blood disorder that doesn’t allow his body to produce the platelets needed to stop bleeding. “He’s a country boy and jewelry isn’t his thing,” Ms. O’Dell says. “It’s a relief for me to know that if he were in a car accident the ER would have his medical history and they’d be able to instantly text me, his parents, his brothers and my mom.”
