Hurricane Charley slammed into Port Charlotte, Fla., in August 2004, packing winds of 150 miles an hour and causing more than $13 billion in damages to the state. The year before Hurricane Katrina would set a new standard for death, destruction, and chaos, Charley sent more than one million people on the Gulf Coast fleeing from the path of the storm and healthcare officials scurrying to make sure evacuees were able to receive adequate care.

And efforts have not stopped there. The California Board of Pharmacy has developed a disaster preparation policy, and pharmacy chains such as Winn-Dixie have created mobile pharmacies that can quickly respond to areas hit by disasters. In addition, a National Association of Boards of Pharmacy task force recently issued 11 guidelines for state boards of pharmacy that address issues ranging from emergency dispensing to compliance with federal laws under emergency conditions.

A Winn-Dixie R.Ph. working in one of the chains new mobile pharmacies

Even before the storm had passed, Medvedeff recognized the system provided a good basis for a true emergency response system. "We realized we could do the same thing on a larger scale," he said. "We learned a lot about what to do."

A year later when Hurricane Katrina hit, Medvedeff was asked by David Brailer, M.D., the national coordinator for health information technology at the Department of Health & Human Services, to join a group to help Katrina evacuees who had fanned out across the country. In addition to Informed Decisions, the team included SureScripts and RxHub. With little notice, the group developed the http://Katrinahealth.org/ Web site, which provided a prescription database that was accessed by 25,000 pharmacies nationwide.

"We were able to look at the largest retail chains that had pharmacies in the impacted zip codes and pull prescription data going back 90 days," Medvedeff recalled. "We were able to get Medicaid claims from Louisiana and Mississippi. And for the first time, Veterans Affairs gave access to its claims data to an outside group for the database."

The http://Katrinahealth.org/ site was, in essence, the test version of the ICERx. Like its predecessor, ICERx pools outpatient prescription medication history information from a variety of sources, including pharmacy benefit managers, community pharmacies, and participating state Medicaid programs. Although the system will not include records from independent pharmacies, Medvedeff estimates that it should have about 75% to 80% of prescription records in most areas. And, like the Katrina site, ICERx brings together Informed Decisions, SureScripts, and RxHub, and it will also include support from the American Medical Association, National Association of Chain Drug Stores, and the National Community Pharmacists Association.