'Invisible bracelet' for emergency health alerts?

[December 22, 2009]  WASHINGTON (AP) -- Emergency health alerts for the Facebook generation? The nation's ambulance crews are pushing a virtual medical ID system to rapidly learn a patient's health history during a crisis -- and which can immediately text-message loved ones that the person is headed for a hospital.

The Web-based registry, invisibleBracelet.org, started in Oklahoma and got a boost this fall when the state's government made the program an optional health benefit for its own employees.

Now the iBracelet attempts to go nationwide as the American Ambulance Association next month begins training its medics, who in turn will urge people in their communities to sign up.

For $5 a year, basic health information and up to 10 emergency contacts are stored under a computer-assigned PIN number that's kept on a wallet card with your driver's license, a key fob or a sticker on an insurance card.

It's a complement to the medical alert jewelry that people with diabetes, asthma and a host of other conditions have used for decades to signal their needs in an emergency.

And it comes as the American College of Emergency Physicians is trying to determine just what information is the most critical for medics and ER doctors to find when you're too ill or injured to answer questions, so that competing emergency-alert technologies don't miss any of the essentials.

"Too many times, we don't have the information to help us treat the patients correctly," says James Finger, president of the American Ambulance Association, the largest network of emergency medical service providers.

Not everyone who should wear a medical alert bracelet does, costing EMS workers precious minutes determining, for example, if someone's incoherent because he's having a stroke or because he's a diabetic with dangerously low blood sugar.

Even someone too healthy for those bracelets may have some condition that could help emergency workers make a faster diagnosis, avoid a medication reaction -- or track down their next-of-kin faster.

The question is how to make sensitive medical data easily accessible to emergency workers without violating federal health-privacy laws. Options range from simple bracelets to pricier key-chain flash drives, implanted microchips -- and call-centers that relay stored health records and notify relatives when an alarm or medic's phone call activates the system.

Rapid family notification is crucial, says Stephen Williamson, president of Oklahoma's Emergency Medical Services Authority -- and one reason his EMS provider recently trained to use the new Invisible Bracelet.

A medical alarm necklace Williamson bought for his mother promptly called an ambulance when she fell, but didn't alert him as promised until 11 hours after he learned of her hospitalization on his own.

And when his wife suffered a brain aneurysm a year ago, Williamson called 911 and got her in the ambulance -- only to freeze, unable to remember how to contact their daughters.

"I'm in the business of emergencies. ... But I just stared at my phone. I couldn't figure out for, honest to God, five minutes it seemed like, 'What do I do?'" Williamson recalls. "I'd much rather have known that's being handled and left for the hospital."

Enter the iBracelet. Only authorized medics can access a Web site that reads the PIN and opens the health info they use to treat. Then, with a push of a button, the medic chooses an area hospital for transport. Simultaneously, the up to 10 people listed to be notified by text or e-mail get that message.

EMS providers couldn't show data yet on how well it works. But nearly 100,000 people have enrolled since the service opened in Oklahoma in April, says Noah Roberts of the Tulsa-based Docvia health software company, and the University of Oklahoma is preparing to use it for a campus registry.

The ultimate goal is an electronic medical record for everyone, available no matter where they are, says Dr. Andrew I. Bern, an ACEP board member and emergency physician in south Florida.

That's years away. Until then, ACEP is preparing recommendations for the most important information to overcome what Bern calls "the limited real estate" on emergency bracelets and wallet cards, and the problem of outdated information when people forget to update their records.

No one's immune: 120 million people needed emergency care last year, Bern notes. So in choosing whichever of today's emergency-information systems most fits your lifestyle, he stresses to keep it up to date.

"You have to be a partner in this whole process, gathering the information," he says. "If it's not current, it's not that useful."

[Associated Press; By LAURAN NEERGAARD]

Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

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