MOCK ANTHRAX ATTACK | Emergency response gauged - June 23, 2006

Digital doc works tirelessly
At a drill in Liberty, a computer program helps process people at a cool, detached pace.

By LINDSAY HANSON METCALF of THE KANSAS CITY STAR (reprinted with permission)

The 200 or so volunteers acted calmer Thursday than they might have been if the anthrax attack had been real.

They filed quickly through a hallway, past a thermal-imaging screen that singled out feverish patients. They consulted volunteers about their medical histories and moved on to clinicians, who gave them "medicine" to fight their disease.

But it wasn't the doctors who decided how much ciprofloxacin or doxycycline to prescribe. That was left to computers.

Area health officials say the computer software, designed by a Northland pharmacist and used Thursday at a drill in Liberty, could be a key piece to saving the city from a bioterrorism attack or an avian flu outbreak.

Federal guidelines say the area should be prepared to medicate its almost 2 million residents within 48 hours, which means processing 500 people each hour at 100 or more sites. Because the software - MEDS/POD - takes the decision-making out of drug dispensing, those emergency sites could reduce the number of clinicians from 50 to five. The name stands for Medical Emergency Decision System/Point of Dispensing.

"If you want to do it fast, you have to sacrifice safety, and I didn't want to do that," said Russell Andrews, the pharmacist and former Cerner Corp. manager who started the Kearney-based software company NexGenisys in the wake of Sept. 11, 2001.

The Mid-America Regional Council secured grants that allowed the software to be installed at 23 area hospitals and eight public health agencies.

"I would say that we are on the leading edge as far as the collaboration that we have as a region to be able to enhance and develop these capabilities," said Dan Manley, an emergency service planner for the Mid-America Regional Council.

Here's how it works: Patients fill out medical history forms and take them to a bank of computers, where volunteers key the information into a database. The system spits out a prescription, based on the patient's allergies, current medications and other factors. Most are fast-tracked to another bank of computers, where nurses or other clinicians verify the prescriptions and dispense the medicine. If it's a complicated case - involving allergies, children or people who can't swallow pills - the patient moves to a station where doctors give one-on-one consultations.

The software is equipped to handle most bioterrorism agents that the Centers for Disease Control and Prevention have identified as easy to produce and disseminate, including anthrax, plague, tularemia and smallpox. The system also can streamline an agency's response to the flu, diphtheria and tetanus, whooping cough, mumps and hepatitis.

Area agencies are beginning to test the software, as they did Thursday at Pleasant Valley Baptist Church in Liberty. About 200 role-playing volunteers gathered to simulate a response to a mock anthrax attack at Liberty High School's graduation. Nurses filled prescriptions for medicines, but instead of doxycycline and ciprofloxacin, volunteers received M&M's and Skittles with labels instructing them to take "one tablet twice daily."

"It's hard to make a mistake," said Laurie Szczepanik, a nurse at Truman Medical Center who was among those doing the dispensing.

Another aspect health officials like is that the system can be queried by ZIP code, a feature that could show who has been medicated or inoculated.

Last fall, six area hospitals and the Clay County Public Health Center used MEDS/POD for their flu clinics.

"It just processes people so quickly," said Jodee Fredrick, a Clay County health center spokeswoman.

Experts say the software is one of many initiatives aimed at protecting Kansas City. And though the system's efficiency depends on an adequate drug supply, such initiatives help alleviate some of the worry.

"I'm glad I live in Kansas City, frankly," Andrews said. "If an event were to happen, I know we can do it better than anyplace else in the country."

To reach Lindsay Hanson Metcalf, call (816) 234-5904 or send e-mail to lmetcalf@kcstar.com