The City of Warwick has offered employees ER Cards that will have all of their medical information embedded in them.

The Providence Journal / Frieda Squires

City employees in Warwick are being offered the chance to enroll in a service that creates a personal health record and makes that information easily available, anywhere, in an emergency.

The optional new benefit is made possible by a $75,000 grant to the city from the Rhode Island Foundation. The city’s 900 employees, and their immediate relatives, will be entitled to free one-year enrollment in ER Card, a West Warwick-based company that helps people gather their basic health information in one secure place and release it to appropriate health-care providers by phone or computer.

The unusual pilot partnership between ER Card and Warwick, the first of its kind, comes amid growing attention to the need to organize people’s health information and use that information to better manage their care. Mayor Scott Avedisian said he hopes it will help improve employees’ health and possibly save the city money. ER Card will also provide Warwick with aggregate information about city employees that can help the city target its health-promotion efforts. (No information about individuals will be released.)

Avedisian said that when he first became mayor, he rode with ambulance crews and was shocked at the “guessing game” the rescue workers went through caring for unresponsive patients. The ER Card makes that scenario less likely. Today, Warwick ambulance crews have laptops connected to ER Card software. They can enter a patient’s name or address and, if the person is an ER Card member, the emergency medical workers will know about the patient’s conditions, medications and allergies before they arrive.

The ER Card takes a different approach from the electronic medical records that many doctors’ offices are adopting. Doctors are computerizing patients’ charts, and a statewide effort is under way to establish a network that will eventually enable doctors, pharmacies, hospitals and laboratories to obtain those records, if the patient agrees. But patients usually can’t obtain or change those records themselves.

The ER Card, in contrast, is developed and controlled by the patient, and contains only the information the patient chooses to enter. The patient is responsible for keeping it up to date, and the record will not include doctors’ notes. But it can include information not typically found in an electronic medical record –– such as end-of-life directives, lists of herbal remedies used, behavioral and mental health issues, information about other household members, and anything else a patient thinks their caregivers should know.

Additionally, the ER Card includes a care-management component. ER Card works with the University of Rhode Island College of Pharmacy to review each patient’s medication records. The company will contact the patient if there are problems, such as inappropriate doses or medications that shouldn’t be taken together. ER Card employees will also contact members four times a year and within 24 hours after someone gains access to their records to remind them to update their record.

“It’s very personal,” Avedisian said of ER Card’s approach. “There’s that voice on the end of the phone.”

ER Card has been in business for 10 years, and has about 10,000 enrollees, most of them Rhode Islanders, according to Maria Gil, managing partner and cofounder. Anyone can become a member for $8 a month for an individual or $6 per person for a family. But now, Warwick city employees can enroll for free for one year.

At a news conference announcing the partnership yesterday, Avedisian said that 100 employees had signed up in the first two weeks. If the program is successful, he said, he would seek money from other sources to continue it beyond a year.

Those who join will complete a questionnaire, either filling it out online or giving the information to ER Card employees by phone, e-mail or fax. The result will be a personal health record stored in an encrypted database, listing the patient’s health conditions, medications, allergies and other essential information. Patients will get a card that displays an ID number, the ER Card toll-free phone number and Web site address.

Three hospitals in Rhode Island –– Landmark Medical Center in Woonsocket, Kent Hospital in Warwick and Memorial Hospital of Rhode Island in Pawtucket –– have installed ER Card’s software. For ER Card patients who show up at those hospitals, the doctors will simply enter their number into the database. Other hospitals can get it by phone.

Additionally, patients can synchronize their record to a USB “flash drive” that they can carry with them and that will work in any computer. Patients can also print out hard copies –– or ask to have them mailed, if they don’t have a computer –– to hand to a new doctor to avoid filling out forms.

Dr. Albert J. Puerini, a Cranston family practitioner, displays ER Card posters in his office and actively promotes it to his patients. “It’s a very cool thing,” he says. “Imagine you’re an emergency room physician with a 70-year-old patient with multiple medical problems, who can’t remember the names of their pills and may not even know all their conditions. This poor ER doc is really in the dark. It’s dangerous.”

Someday the nation may develop a fully integrated electronic medical record system that would enable the emergency doctor to look up the patient’s information.

“If that happens locally and nationally, ER Cards probably won’t be necessary,” Puerini said. “But that’s way down the road.”

Laura Adams, executive director of the Rhode Island Quality Institute, which is leading the state’s effort to develop an electronic medical-record network, says she thinks the ER Card may always have a role, even if the institute’s efforts succeed. Patients might link into a health information network and download their lab results or lists of medication into their personal health record. Or they might do the reverse –– add information such as end-of-life wishes to their electronic medical records.

ffreyer@projo.com