The view from inside major medical centers
KELLY: Yeah, Ron.
KAHN: Could I make a comment because I think that this mental health also falls into the chronic diseases that are often requiring medication. So you have a large percentage of people on chronic medication, and I do think this is an area where again we need to give thought to the issue of how we make sure that during emergency preparedness and all of these other considerations that we identify those people who are on chronic medications, make sure somehow that either they have their medications or we have developed a system where we can identify what medications they were on, whether it be a digitalized card that carries health information or some sort of computer chip or something as simple as a system where their health records can be accessed, you know, with HIPA concerns and all the other health privacy concerns. Sometimes we may have concerns that actually prevent access to critical information. So we need to find the right balance, and I think that patients with chronic mental illness and chronic diseases like diabetes or heart disease will all be in this special category with each different considerations of how they need to get their medications. But lack of medication is identified as one of the major problems in the recent Katrina disaster for all of these chronic diseases.
KELLY: Where are we? Alex, back there.
Q: Avery Comarow, U.S.News & World Report. As I listen to the different views expressed, a thought occurs to me that a lot of what you're talking about requires local planning at more than just your hospital level, whether it's the local county medical society, whether it's a consortium of hospitals. It sounds to me as if it is as important for the hospitals within an area to figure out what certain hospitals will not do and what other hospitals will do rather than trying to view this as trying to do the most that a particular individual hospital can do. And this is especially true, I think, because so many hospitals these days are staffed by agency nurses and temp nurses and who knows where they'll be. How successful are you in listing the cooperation of hospitals in your communities to divide up the responsibilities, the resources, the training, the responses, everything that goes into meeting emergency or surge needs?
BURKE: I think that I'll be happy to respond to that. I think we're very successful within the city and county around Houston and Harris County, there is a very good emergency network of hospitals. We routinely report open bed capacity, most of the hospitals have planned to work toward their strengths in a disaster area. As I mentioned earlier, we have unique opportunities with immuno-suppressed people. We have other hospitals in our center that have unique opportunities with trauma care. We have others that manage heart and other diseases well. And so, we have tried to partner and work to the strengths of each institution. We've also worked with the county emergency medical services to have contingency plans to activate non-hospital facilities for large volume casualties, and that's been a partnership amongst all of the hospitals in the region.
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