When Hurricane Katrina hit Louisiana on August 29, 2005, the more than 10 feet of water that broke through the levees protecting New Orleans flooded 80 percent of the city. The floods, said Bethany Bultman, president and director of the New Orleans Musicians Clinic (NOMC), located in the Freret neighborhood at the time Katrina hit, “took out cell towers, they took out every kind of communication.” The flood also destroyed the paper records for the clinic’s 837 patients, many of whom were temporarily or permanently displaced by Katrina. In 2005, Bultman said, “Nobody had electronic medical records.”
NOMC patients are uninsured-and under-insured musicians working in New Orleans’ live music industry as instrumentalists, vocalists, choir members, members of social aid and pleasure clubs, and Mardi Gras Indians, among other musical jobs. The clinic estimates New Orleans musicians’ average annual income is around $15,000. NOMC provides care for a $10 co-pay.
After the flood, like more than a million New Orleanians evacuated to other states, musicians and NOMC staff were scattered across the country. Without a functioning clinic or patients’ medical records, “we had to be incredible detectives,” Bultman said. To make sure the musicians (more often than not, Bultman calls the clinic’s patients “musicians” rather than “patients”) were accounted for and their care could continue, NOMC used billing records to find their residential addresses and determine whether they lived in an area that had been massively devastated, like the Lower Ninth Ward, and were likely displaced, or in an area less affected by the storm, in which case a NOMC volunteer would be sent for an in-person visit.
Doctors nationwide helped treat displaced musicians. When Bultman managed to connect with a musician, she found specialists local to them who could take over their care and unravel unknowns about their condition. For example, a musician may have known they had throat cancer, but without a medical record they may not have known what kind of throat cancer or the type of chemotherapy they were getting. NOMC arranged with local doctors to figure out patients’ histories so they could continue their treatments.
By Thanksgiving 2005 the clinic had reopened; it was one of the first clinics to start seeing patients again after Katrina. NOMC now operates in New Orleans’ Garden District, with about 2,500 active patients, more than double its pre-storm case load, receiving both occupational and comprehensive healthcare. Often, drummers come in with sciatica, trumpeters come in with earaches—acute health issues that interfere with their playing and livelihood. NOMC clinicians see all patient visits as an opportunity to also assess overall health and start treating chronic conditions.
Thanks to post-Katrina federal grants, NOMC patients now have access to Louisiana State University Health Network’s electronic health records (EHRs). “It’s life-changing” for this demographic, Bultman said, since musicians are often traveling to perform and rely on their bodies to make a living. Though Katrina’s disastrous weather severed patients’ connection to their medical home and medical information, today NOMC musicians can access information on all their conditions, reach their doctors, and order prescriptions from a cell phone anywhere in the world.
What the musicians went through after Katrina demonstrates, in Bultman’s mind, why EHRs are so important. “We can never have anything like that happen again. If people think they can’t afford to have electronic medical records, or to make sure they’re accessible, they need to realize that people’s lives are at stake,” she said.