UNLV to archive medical records of NTS workers

Jennifer Knight

Monday, March 18, 2002 | 10:57 a.m.

In an experiment that could revolutionize how doctors approach nuclear industry health issues, computer experts at the University of Nevada, Las Vegas are preparing to digitally archive a massive amount of medical records of former Nevada Test Site workers.

The UNLV project would establish Nevada as the nation's repository for electronically stored Energy Department health records. With a unique ability to digitally store and transmit crucial data, its technology also could have far-reaching effects in the private sector, UNLV officials say.

"Imagine a former DOE employee has filed a claim for his participation in nuclear testing and maybe he has an abnormal CAT scan," said Tom Nartker, a computer science professor for UNLV's Information Science and Research Institute. "You might be able to query the system and ask the computer to show all other scans with the same abnormality."

The database would allow doctors to search for patterns in radiation-related illnesses with the touch of a button, rather than hunting through medical records and industrial reports that currently are stored in paper morgues throughout the nation.

Ideally a patient's medical history would be linked with other DOE records, such as which area an employee was working in, what type of contaminants were present and what the level of radiation was at the time.

That information -- critical to doctors working with radiation exposure data -- is not currently linked to patient records, Nartker said.

The federal government has allocated $9.4 million over three years in seed money for the UNLV Records Project.

"At this point, this is only an investigational study," said Bill Bunn, a health systems specialist for the DOE's National Nuclear Security Administration, which oversees experiments at the Test Site. "If the DOE funds this as a program, it will mean millions and millions of dollars for Nevada."

Sen. Harry Reid, D-Nev., has helped secure funding for the project on a year-by-year basis, but permanent funding would have to be included in the president's budget, a Reid aide said.

"The senator will continue to fund the program as he has in the past," spokeswoman Tessa Hafen said. "But in order to make it a permanent repository for a national database, that would be up to the president."

UNLV researchers as soon as this summer will begin electronically scanning records -- some dating as far back as 1951 -- on current and former Nevada Test Site workers. Eventually, the project could expand to include medical records from other nuclear arms facilities.

The architects of the project face an enormous task, considering security on the database system must be top-notch and the voluminous amounts of information will take up considerable computer space.

Records on former DOE employees in Nevada alone are stored in three separate facilities. There are an estimated 126,000 medical records to pore over, as well as an unknown number of industrial hygiene records and information on 1 million radiation film badges, which were used to measure radiation exposure on 50,000 employees through the years.

"I don't think that anyone understands how huge this project really is," Bunn said. "Over the years, we have collected a lot of stuff."

The information is expected to take up at least 100 terabytes, or 100 trillion bytes -- hundreds of thousands of times more information than the most powerful personal computer on the market can hold.

Not many computer centers have the ability to store such vast databases. UNLV was chosen, in part, because of the high-powered machine at the university's National Supercomputing Center.

A top-of-the-line "cyber-security" policy for the project is already pending DOE approval, Joseph Lombardo, the center's manager, said.

"Theoretically no one will be able to hack into it," Lombardo said. "Supposedly, when you pass this (level of compliance), it is very secure."

Once the electronic scanning begins, the project is expected to take three to six years to complete, Nartker said.

The development of the nation's first searchable medical records database for former nuclear workers comes seven years after Congress passed a law requiring the DOE to evaluate the long-range health of former employees.

Since then 15,000 workers have undergone health screenings at 14 sites throughout the country. A large percentage of them have experienced significant health problems as a result of their work with the DOE, according to a DOE progress report completed six months ago.

The prospect of having electronic access to the information is promising for epidemiologists such as Lew Pepper, a Boston University professor of public health who is overseeing Nevada's health screening program.

"It's probably revolutionary that the Department of Energy is thinking about doing this," Pepper said. "It's a good idea that the records should be collected and (digitally) archived. For an epidemiologist, it is very difficult to get radiation exposure information."

Once all of the information is scanned, a sorting process will begin. Specialists at UNLV's Center for Health and Informational Analysis will sift through all of the files and work with computer experts to create a sort of "web browser" for medical information, Joseph Greenway, the center's director, said.

The revolutionary aspect of the project lies in the way information will be compiled. Eventually, every part of a medical file -- including three-dimensional diagnostic tools like CAT scans or MRIs -- could be included in the database, Nartker said.

Uses for such technology could also spill over into the private sector, Stephen Rice, UNLV's vice provost for research, said.

"This kind of computerized medical technology ... will provide a level of care to people in remote areas who don't have doctors or medical experts working in their community," Rice said. Ideally a patient or a rural doctor could electronically send crucial records to a medical expert to get a diagnosis, he said.

The DOE and UNLV also are working with local companies in the private sector to make the information as usable as possible. A company called QUEST was hired to visit four other nuclear facilities and learn how their computer systems work.

The facilities each have unique systems, because during the Cold War they were not set up to communicate with each other, Bunn said.

If the UNLV Records Project becomes a permanent program, Nevada's reputation in the field of technology will surge, Bunn said.

"Once you get this little nexus of technology going, it will grow," he said. "From there, so much more can happen."