EHR Adoption in NYC Jails Improved Inmate Care, Study Finds

August 8, 2014 in News

The use of electronic health records in New York City jails helped officials monitor and improve inmates’ care and further protect their human rights, according to a study published in the Health and Human Rights Journal, MedCity News reports.

The study noted that prison inmates tend to have “high rates” of pre-existing health conditions, particularly from mental health issues or violent injuries.

Further, the researchers said that the large amounts of data gathered in jail settings make it “extremely difficult” to collect “sufficient details to detect vulnerability among patients who are subject to abuse or neglect, or to identify those with special needs” without EHRs.

Details of Study

For the study, researchers took part in an EHR implementation pilot project involving 12 New York City jails from 2008 to 2011.

The researchers first attempted to identify populations of prison inmates who were:

  • Vulnerable due to mental illness or injury; or
  • In high-risk settings, such as solitary confinement.

They then adapted an EHR system to better monitor inmates’ conditions and improve care.

According to the study, the EHR system used for the prisons required “substantial modification” to meet the inmates’ needs, including integrating tools for:

  • Dispensing medication;
  • Hemodialysis;
  • Infirmary care;
  • Medical emergencies;
  • New prison admission intakes;
  • Newborn nurseries;
  • Reporting mental health issues;
  • Solitary confinement rounds; and
  • Sick calls.

Findings

The study found that the pilot EHR project significantly improved care coordination and human rights issues by:

  • Flagging inmates who should not be put in solitary confinement or need to be transferred to a hospital;
  • Identifying patients with mental health issues or other vulnerabilities;
  • Implementing policies to mitigate patient vulnerabilities; and
  • Using prisons’ EHR data on inmate abuse, neglect or other human rights issues in conjunction with data from outside EHRs collected via health information exchanges to identify and provide assistance to vulnerable patients.

The researchers noted that efforts to connect the prisons’ EHR systems with health data exchanges “will require significant educational collaboration with community health providers around the key pieces of information that may indicate jail-based vulnerability” (Verel, MedCity News, 8/8).

Further, the study found that by the end of the pilot project, inmates and jail staff saw the EHR “as an important tool for improving clinical care” and that the EHR was being used to record about 30,000 interactions with patients per month (Glowa-Kollisch et al., Health and Human Rights Journal, 2014).

The researchers said they intend to add more tools to the system in an effort to improve patients’ human rights and increase inmates’ participation in the EHR process (MedCity News, 8/8).

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