Correctional systems are looking to technology to improve care and reduce costs, but complex IT projects are not necessarily required to achieve good outcomes, according to a draft report from Community Oriented Correctional Health Services.
The expansion of Medicaid has meant more offenders receive coverage upon release, but many have unaddressed health issues that require careful case management.
The report presents nine case studies of organizations trying to deal with inmate substance abuse, mental illness and recidivism. The organizations are at various points in technology adoption.
- The Time for Change Foundation in San Bernardino County, California, does not use an electronic health record with its Positive Futures Program, which supports female offenders re-entering their communities by addressing substance use and mental health issues. Given that the county is still developing the architecture for its EHR, and that community health centers are only now piloting connectivity to the health information exchange, the organization decided to focus on doing what it does best--letting larger organizations with more resources lead the charge on developing new technology systems. Instead, it finds communication and data-sharing more effective face to face, by phone or fax.
- In Louisville, Kentucky, a coalition of providers and public officials called the Dual Diagnosis Cross-Functional Team (DDCFT) is working to created a single data repository and case-management system across providers to help deal with the opioid-abuse epidemic. It's repurposing an existing program that's part of the Louisville's Homeless Management Information System called ServicePoint to track, treat, and manage system "frequent fliers." ServicePoint can become a single source of information such as who should be contacted, the types of medications an individual may be using, and who is in charge of providing case management. It also can be used to compare the effectiveness of various interventions. While the system does not have total buy-in from the provider community, DDCFT is exploring how ServicePoint could be used in combination with provider EHRs and Kentucky's Health Information Exchange (KHIE).
- The Pima County (Arizona) Justice Health Information Data Exchange illustrates the idea that having clear goals--even small ones--can deliver big results. The county requires that the seriously mentally ill be segregated from the general population, but determining that at intake was never easy. In 2013, Pima County received a grant to automate behavioral health query from multiple area systems to determine whether a person had been treated previously. That system now is in production, making information about previous treatment available when a person is being assessed at booking. The system has some bugs that are being worked out.
To learn more:
- read the report (.pdf)