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Wednesday, March 8, 2006
Last modified Tuesday, March 7, 2006 9:57 PM PST

Program puts migrant workers' health records online

By: JULIANA BARBASSA - Associated Press

BOYES HOT SPRINGS -- Migrant workers stream through the United States each year, harvesting everything from California raisins to Alaska salmon -- and leaving behind precious medical records with each move.

When field workers need a prescription for diabetes, or vaccination records to enroll their kids in a new school, tests have to be retaken and immunizations repeated, a process that frustrates doctors and wastes taxpayer dollars.

Now, a free pilot program is putting their records online, connecting Sonoma Valley farmworkers to their medical history, wherever they travel, as long as there's a computer at hand.

MiVIA, which means "my way" in Spanish but also stands for Visitor Access Information, was created by Medical Management Resources, a small Sonoma technology company. It began in 2003 as a partnership with Vineyard Workers Services, a farmworker advocacy group, with the goal of making health care more accessible to seasonal workers.

This shifting population often has difficulty getting to a hospital or seeing a doctor. They're often Spanish-speaking, undocumented and uninsured. Having to constantly switch providers throws up another hurdle, but MiVIA brings them a step closer, its developers say.

"These are people who work hard and have more than their share of medical conditions," said Cynthia Solomon, head of Medical Management Resources. "It's hard for them to access care, but when they do, they start treatment and leave for the next town, the next crop. They leave that information behind."

At first, some farmworkers without legal work documents were reluctant to provide so much identifying information. But as MiVIA grew, trusted members of the community were enlisted to help spread the word.

"I had to tell them this wasn't going to end up in the hands of immigration," said Jose Fernandez Figueroa, who works for Vineyard Workers Services and has been telling farmworkers about MiVIA since its inception three years ago.

Holding up his own MiVIA identification card, he said, "there's a lot of fear, but these are safe."

The pilot program focused on families who move through California's wine country harvesting grapes. They spread the word, and soon MiVIA mushroomed from an experiment with 50 workers to a network of 2,200.

"I just feel safer," said Ramiro Garcia, 37, who works construction between jobs picking grapes. "If I have an accident at work, if I feel sick, I can just give them this card and they'll know everything they need to know about me."

MiVIA now reaches only a fraction of the hundreds of thousands of farmworkers in California. But hospitals and clinics in the rural San Joaquin Valley will start enrolling participants in the spring. Program developers expect another 1,000 workers to join in Napa and Sonoma by June, and they're fielding inquiries from interested groups from Oregon to Florida.

The program is simple: Users get a laminated identification card with their picture, address and emergency contact information. Patients also have a secret password that gives doctors access to their medical history and lets them add everything from new prescriptions to X-rays.

If patients forget how to take certain drugs or want to review their files, they can look the records up themselves. The Web site connects them to an online bilingual medical reference guide, and to resources useful for a traveling population -- where to find housing, public transportation, clinics and dentists.

The site is secure and complies with federal laws protecting private health information. No one can access the information without the patient's password, says Yelena Wenograd, who designed and developed the software.

"It just made the best sense possible," said Kathy Ficco, a nurse with St. Joseph's Health System in Sonoma County. "You avoid misinformation and spending hours on the phone to get records."

For the first three years, Medical Management Resources didn't charge providers, relying on grant money to pay for its development and growth. Now that the MiVIA is expanding, the network is starting to charge clinics and hospitals a one-time fee of $1,950, plus $100 a month per account. It will always be free to users, Solomon said.

Though it was designed for farmworkers, it could benefit anyone in an age when so many move to attend school or take jobs, proponents said.

"Immigrants, they don't carry papers like medical records when they move from place to place, or across the border," said Xochitl Castaneda, head of the California-Mexico Health Initiative at the University of California. "But this could work for all people, everywhere. Americans a lot of times don't take their health records when they move either."