Restoring Patients’ Paper Trail : Health: Hospitals and medical offices have been trying to resurrect records damaged in the quake. Changeover to computers has been considered not cost-effective.

Hal Miner, an administrator with Kaiser Permanente, remembers the Sylmar earthquake vividly, even though it was more than 20 years ago. What he cannot forget is that he was literally buried under an avalanche of medical records.

“I was working as a chart clerk in the basement,” he recalled. Miner said he was knocked over when the quake hit, then buried under charts.

As a result of the Northridge earthquake, Miner, who is now in an administrative post where he is responsible for 300,000 patient records, once again has been confronted with massive piles of paper shaken loose by a temblor.

Miner is part of a broader circle of medical industry record-keepers who have been struggling to sort out the damage to crucial paper records in the earthquake.

Hospitals from Santa Monica to the Santa Clarita Valley were inundated when the earthquake spilled thousands of patient records from filing cabinets and storage shelves.

Given the capabilities of electronic storage, the sight of physicians and others sorting through rubble for scraps of paper was in its own way as primeval as the post-quake impressions created by seeing quake victims eating at open-air fires.

Despite the push to computerization and paperless offices elsewhere in the economy, hospitals and medical offices for the most part still handle patient records the old-fashioned way: by hand-packing them document by document into cardboard folders, then stuffing them into metal racks, bookcases or file cabinets. After a while, the older records are packed into boxes and carted off to a warehouse for permanent storage.

Hospital administrators and heads of medical offices say they continue the old-fashioned system because it works and is cost-effective. Given the potential for the wholesale loss of patient records, they say they came through the earthquake in reasonably good shape, with major damage only at a few sites. Water damage to the documents was widespread, but highly evolved freeze-drying methods allowed nearly all to be salvaged.

The difficulties they faced in hanging on to their records may have been a warning call to move on from their traditional way of doing things.

Some psychiatrists lost crucial tapes of patient interviews, or notes they wrote up over years as they chronicled a patient’s care. Dental records, often used to identify the dead, were lost.

Ron Spoltore, a health care specialist with Kenneth Leventhal and Co., a national accounting and consulting firm, said: “There are some records you just can’t reconstruct. As a result, patients are at risk. . . . If a patient were to die, and it could be proved that not having access to the patient’s record could have been critical to saving that patient’s life, it could be a big issue.”

Santa Monica dentist Al Rosenblum said all his patient records were lost when the six-story Barrington Medical Building at Olympic Boulevard and Barrington Avenue was destroyed by a wrecking ball.

Rubble from the Barrington Building was taken to the dump. All that remained was a limited number of files that were put into several dumpsters. Dentists, psychiatrists and friends spent a recent weekend sorting through them looking for documents from their offices.

Experts in the computer industry say technologies exist that could solve most of the problems caused by the quake. Many companies offer imaging systems that can scan a document and reproduce it inside a computer, acting like copiers. There are also electronic notebooks that can convert scribbled prescriptions and physician’s notes into text that can be stored inside a computer. Companies also offer off-site or out-of-state computer storage systems.

Computers and computerized records are used in a limited way in the health industry. They provide the technology necessary for complex medical procedures and laboratory tests and are the backbone of mass billing systems.

Why, if computers can spit out bills or scan a heart, can’t they also be used to maintain a patient’s medical history?

Hospital officials universally cite cost as the biggest reason for not converting completely to computers. They also say that technologies are not developed enough to suit their medical needs.

“Tradition has a lot to do with it,” said David Langness, a spokesman for the Hospital Council of Southern California.

Many in the industry believe a possible solution lies in President Clinton’s proposed health reform plan. Clinton wants a computerized national health system that will provide for permanent storage of patient records.

Langness said the earthquake may have been a wake-up call for the health industry.

“There is already a lot of work going on in this area,” he said. “There are many people interested in getting hospitals into the 21st Century. Maybe what the earthquake has done is point up that we are going in the right direction but that maybe we are not going there fast enough.”