Electronic health record use can be expanded to help jails reduce the costs of providing care and improve health outcomes, according to new research published in the March issue of Health Affairs.
The article--written by Judy Murphy, deputy national coordinator for programs and policy at the Office of the National Coordinator for Health IT, and Ben Butler, CIO at Community Oriented Correctional Health Services in Oakland, Calif.--points out that jails, which are required by law to provide medical care to people in custody, have many of the same issues as other healthcare providers. However, they face "unique" challenges in providing care, including a mostly uninsured, mobile population with a high rate of substance abuse, behavioral health issues and chromic diseases. Such patients also typically don't have medical support once they leave jail and return to their communities.
Each year about 10 million people are in custody either as detainees or as incarcerated individuals.
Recent laws, such as the HITECH Act's Meaningful Use program and the Affordable Care Act's expansion of the Medicaid program, have helped jails adopt EHRs and inmates obtain outside coverage. As a result, jails are venturing into EHRs in a myriad of ways, including developing systems internally, integrating EHRs with offender management systems, and engaging in health information exchange with the outside community, which have resulted in particular struggles over confusion with HIPAA privacy laws and access to patient records.
ONC is looking at ways to segment substance abuse information, which enjoys enhanced privacy protections.
The Centers for Medicare & Medicaid Services expanded the Meaningful Use program to correctional providers in 2012, although they've encountered some obstacles in attesting.
"As policy makers have struggled to find ways to control soaring healthcare costs, it has become clear that those efforts cannot succeed without taking into account the substantial healthcare costs incurred by the jail population," the authors said.
To learn more:
- read the abstract