The Christchurch earthquake--providing a rheumatology service during a natural disaster.

To report on the effects of the Canterbury earthquake on rheumatology service provision and identify factors that allowed continuation of patient care. Data was collected on the number of appointments during the period after the earthquake and the effects of the earthquake on service provision. The rheumatology service faced unique challenges in continuing to provide a service and ensure ongoing care for our patients in the community after the earthquake. All outpatient services were cancelled for 2 weeks, resulting in the cancellation of 23 new patient and 145 follow-up patient appointments. Telephone consultation was attempted for all these patients. A total of 113 patients could be contacted, and 15 required acute review. Challenges included difficult access to the hospital, lack of laboratories for blood testing, limited access to clinical records, loss of power, sewerage and waste water and a contaminated drinking water supply. The impact of these on patients with rheumatic diseases was wide ranging. Despite a natural disaster and challenging logistics, the Rheumatology Department was able to provide a service with the use of remote telephone consultations and an electronic patient record backed up by an effective patient and primary practitioner education base and resource access.