Health IT

Health Information Technology (Health IT) holds out the promise of improving healthcare for individuals both in the community and in correctional environments. Moving from paper records to electronic health records (EHRs), many jails have achieved some level of continuity of care for individuals cycling in and out of facilities, making it easier to locate records from previous stays.

Health Information Exchange (HIE)

But healthcare within corrections even for those facilities with EHRs are isolated from the rest of the community. One technology that can help promote continuity of care between corrections and the community is health information exchange (HIE). Multiple HIEs have been implemented throughout the country. These HIEs can be statewide, regional or local. EHRs connected to HIEs share their medical records with the HIE as well as allowing providers to see medical records generated in other sites of care. Given the high morbidity rate of people cycling through jails, HIEs can assist providers in corrections be better informed about the care they are giving.

The Unseen Provider
The Unseen Provider: Healthcare in Our Jails is a short documentary that explores the great potential health information exchange (HIE) presents to correctional institutions wanting to achieve continuity of care with community providers.
Health Information Exchange between Jails and Their Communities: A Bridge That Is Needed under Healthcare Reform
This article presents two case studies: one in which a single champion made the decision to link the jail health care system to the local HIE and the other where all stakeholders were included in the process.
Jails And Health Information Technology: A Framework For Creating Connectivity
Across the United States, increasing numbers of local and county jails are exploring health information technology solutions that can help them achieve more efficient and better coordinated care.
Health Information Exchange And Jails
Health Affairs
In a letter to Health Affairs, COCHS’ CIO, Ben Butler, writes that HIEs in jails present an opportunity to study how HIEs can affect the health care of a clearly defined set of people and see whether it increases efficiency, improves quality, and lowers cost.
New HIE Funding Opportunities for Corrections
The Centers for Medicare and Medicaid Services has expanded the list of providers that could participate in the 90 percent federal matching rate (90/10) for state activities to promote HIE activities. The expanded list includes correctional health providers.
Electronic Health Records and Human Rights
Electronic Health Records (EHRs) not only provide ready access to a person’s health records promoting continuity of care but can also help track abuses that might occur within corrections.
The EHR as a Human Rights Tool
Dr. Homer Venters, Assistant Commissioner of Correctional Health Services, New York City Department of Health and Mental Hygiene, explains how EHRs in corrections can be used as tools for monitoring human rights.
The Triple Aims of Correctional Health: Patient Safety, Population Health, and Human Rights
Medical College Journal of Health Care for the Poor and Underserved
One of the greatest interventions in service of patient safety and human rights in corrections is the adoption of an electronic health record (EHR) with integration to health information exchanges.
Data-Driven Human Rights: Using the Electronic Health Record to Promote Human Rights in Jail
Health and Human Rights Journal
The EHR in New York City's Rikers Island was modified to allow for better surveillance of vulnerable populations and enable reporting and analysis of patterns of abuse, neglect, and other patient concerns related to human rights.
EHR Challenges
While COCHS has the perspective that electronic health records (EHRs) in corrections provide a level of transparency that can assist in monitoring human rights, especially in reference to injury reporting, it is apparent that there are multiple challenges with EHRs. COCHS in no way recommends or promotes specific vendors. The articles written by COCHS' staff are solely informational.
Death By 1,000 Clicks: Where Electronic Health Records Went Wrong
California Healthline
The software in question was an EHR, made by eClinicalWorks (eCW). It didn’t take long for Owen Foster, a newly hired assistant U.S. attorney with the District of Vermont, to assemble a dossier of troubling reports suggesting the company’s technology didn’t work quite the way it said it did.
HITECH and Meaningful Use
Although corrections is isolated from the rest of the community sometimes policy changes or legislation will impact this environment. This is especially true with the Health Information Technology for Economic and Clinical Health Act (HITECH) and its Meaningful Use incentives for the adoption of EHRs. In some jurisdictions, this legislation helped to promote the adoption Health IT within jails.
The Impact Of Policies Promoting Health Information Technology On Health Care Delivery In Jails And Local Communities
Health Affairs
The current policy landscape, shaped by the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Affordable Care Act, is favorable to jails’ implementation of health information technology (IT).
Meaningful Use and Corrections: Unknown Opportunities
Meaningful use is the linchpin of the Medicare and Medicaid EHR Incentive Programs, established under the Health Information Technology for Economic and Clinical Health (HITECH) Act to provide incentive payments to eligible providers which include can include providers in corrections.
Meaningful Use of an Electronic Health Record in the New York City Jail System
American Journal of Public Health
Use of EHRs is an important innovation for patients in jails and prisons. Efforts to incentivize health IT, including the Medicaid EHR Incentive Program, are generally aimed at community providers; however, regulation changes allow participation of jail health providers.
Electronic Medication Administration Records and Other Technologies

Many jurisdictions have used technology in innovative ways to face the challenges of healthcare within corrections. COCHS has highlighted many of these implementations including predictive analytics, electronic medication administrative records, and interfaces between jail management systems and health IT.

Prescribing and Dispensing Medications within Correctional Environments: The Role of Health Information Technology
Going to a pharmacy and filling a prescription is not an uncommon experience. Within the correctional environment, this process, like most, becomes far more complicated.
Technology and Continuity of Care: Connecting Justice and Health
Diversion and reentry programs require information: information about health, information about treatment providers and social support services, and information about when someone is arrested. This data is located in different systems and coordinating across silos is a challenge.
Predictive Analytics in Health Care and Criminal Justice: Three Case Studies
Organizations in both the healthcare and criminal justice have been using predictive analytics, but predictive analytics are just beginning to be used in what may best be described as the hybrid field of healthcare and criminal justice.