Health IT in Prisons & Jails
Background
According to the United States Department of Justice, in 2007 2,299,166 individuals were held in federal prisons, state prisons and local jails. The number of prisoners is increasing at roughly 2.5% per year. Individuals housed in prisons and jails receive their entire healthcare through the facility in which they are housed or through clinics and hospitals with which the department of corrections contracted. There are many challenges to healthcare administration in prisons and jails including the lack of medical insurance and loss of Medicaid and/or Medicare coverage. Additionally, incarcerated populations have dramatically increased rates of substances abuse, mental illness and communicable disease than the rest of society[1].
Clinical Information Systems
Clinical information systems like those provided by Prison Health Services Inc. are important for quality of care in prison or jail as well as ensuring continuity of care after release. The Catalyst system used by 22 states has some decision support features with limited alerting capabilities. PHS is currently looking to have Catalyst certified by CCHIT Utilizing a good CIS can save state tax payers millions of dollars by improving health care and lower inmate health care costs. A majority of prisons do not use electronic medical records, and rely on paper-based systems. This poses a hurdle to providing quality care and ensuring continuity of care because often inmates transfer between institutions and in and out of custody. Prison health care could greatly improve with the implementation of EHR. One major challenge to implementation is funding for infrastructure improvements like high speed fiber-optic networks and fast local area networks.
Telemedicine
Telemedicine is an important tool to provide inmates with quality care while minimizing health care costs. Without telemedicine inmates must be transported to outside facilities under the supervision of one or more paid officers to receive services that are not provided in housing institution. One of the most common types of services utilizing telemedicine is radiology. Expanding telemedicine capabilities and extending them to all prisons will maximize the economic benefit to tax payers.
References
- Glaser, J.B. and R.B. Greifinger, Correctional health care: a public health opportunity. Ann Intern Med, 1993. 118(2): p. 139-45.
