Health care has become one of the largest expenditures for corrections programs nationwide. The amount spent on health care is growing annually at the rate of ten percent. This alarmingly fast rate of increase in health care spending has prompted the correctional community to look for new models and strategies for managing the correctional health care environment. Health Information Technology (HIT), and more specifically an Electronic Health Record (EHR), is seen by many as the ultimate tool for improving the quality of health care delivery, lowering health care costs, and providing better information for patients and physicians.
Although EHR systems in custodial communities have not been studied extensively, they are expected to provide valuable benefits in correctional settings, ranging from restraining growing health care costs by increasing efficiency and accountability, to improving public safety by eliminating inmate travel to specialty care appointments, and improving quality of care for inmates by offering easy and timely access to accurate and continuously updated medical records. The public itself is expected to benefit as well from the overall improvement in the health of inmates both while incarcerated and after their release.
The adoption of a fully automated health record has far-reaching implications for the New York State Department of Correctional Services (NYS DOCS), for inmates themselves and for all the organizations involved with NYS DOCS’ inmates before, during, and after their incarceration. The work practices of every staff member with even the most minor connection to an inmate’s health care will be affected. The NYS DOCS has successfully invested in the automation of related processes and is continuing to work towards full potential of an EHR.
CTG's three phase project helped identify the policy, management, and technology issues related to the adoption of an EHR within NYS DOCS The final project report, Setting the Stage for an Electronic Health Record: A Business Analysis for the New York State Department of Correctional Services, presents findings from an in depth analysis of the factors influencing a movement to an EHR and recommendations to achieve that goal.
The project was carried out in three overlapping phases.
Phase one involved research on the EHR landscape in the United States generally and within the context of the correctional community, as well as research on the commonly agreed upon costs and benefits associated with EHR adoption and use. CTG conducted site visits and teleconferences with agencies and correctional departments of other states that have or are in the process of adopting EHR systems.
Phase two focused on the development of a comprehensive description of the medical services environment in NYS DOCS. This included the identification and high-level modeling of key business processes associated with medical care in NYS correctional facilities and the primary stakeholders in these processes. The project also included an analysis of the various aspects of the medical record itself and related policies and management issues such as HIPAA and enterprise-wide data standards.
Phase three focused on a more detailed analysis of the policy, management, and technology issues related to the adoption of an EHR within NYS DOCS. It was comprised of interviews with staff from a number of medical services units throughout the state. The challenges facing medical services unit staff as they deliver medical services to inmates and their perspectives on the costs and benefits related to the adoption and use of an electronic medical record were explored during these interviews.
New York State Department of Correctional Services (NYS DOCS)