Impact of Information Data Integrators in the US Correctional Health System

Juan M. GarciaLT-36 Seton Hall University

Points to Consider

• US has the largest prison population in world, most are incarcerated due to non violent crimes.

• Correctional Health must provide equal quality treatment to that available in the community. However, there are many instances of inequality.

• Law suits for malpractice due to poor established procedures.

Characteristics of Correctional Health Care

• Focuses in costs, provides in-house treatments.

• Difficulty recruiting and retaining the best staff.

• Serves special populations with unique

characteristics like teenage girls, aging population,

and minorities with limited access to health care.

• It is expensive. It treats chronic conditions as TB,

HIV, hepatitis and mental illnesses.

• It has high exposure to litigation.

External Factors - Demographics

• Aging correctional population, growth over 500% of population over 50. – It costs 3 to 9 times

more to take care of an older population.

– High impact in Medicare

• Teen Age Girls– Mental Illness– STD’s– Pregnancy– Child Care– Impact Medicaid

• Human Resources– Poor Recruiting– Burn Out Staff– Dual Loyalty

Other Factors – Correctional H.C.

• Responsibilities– Free access to

care– Equivalence to

community care– Confidentiality– Patient Consent– Humanitarian

Assistance– Professional

Independence

• Ethical Factors– Awareness of medical and

human rights principles– Staff trained in ethics,

medical law, and human rights

– Follow international guidelines

– Patient inclusion– Continuity of Care– Epidemiology surveillance

Challenges for Correctional Health Institutions

• To reduce costs while providing services

similar to those offered on the free community.

• To obtain and to share patient information

when a person is detained, moved from a

correctional facility to another, moved to a

hospital, or placed on the free community.

• To be compliant with ACA, HITECH, HIPAA.

• Growing number of prisoners in the US and

aging of incarcerated patients.

Ethical Considerations

• How important is the health of a prisoner?

• Do prisoners deserve excellence of care for expensive diseases?

• Should the penitential HCO facilitate care once they leave the system?

• Do prisoners deserve confidentiality?• When to send a prisoner to the

hospital?

A Data Integrator• Enables communication with internal and external

systems under a single platform.

• Is a powerful reporting tool that facilitates quality

improvement while enabling cost and complexity

reduction.

• Has the capability to establish and control performance

indicators, billing, EHR, telemedicine.

• Enables integration with other health care providers

and regulators.

• Examples of Data Integrators are: Corepoint, IBM,

IMS.

IMS & Corizon Health Care

• CHC– Private Largest

Correctional HCO– 27 states 500

facilities.

• IMS– Cloud Based– Data Integrator– Cost Efficient

Financials, E. (n.d.). Retrieved from http://www.ecsfin.com/ (n.d.). Retrieved from http://www.corizonhealth.com/

Current Situation in CHC

• Medical and Managerial committees for quality and operational discussions.

• Mean communications done through email and conference calls.

• No Electronic Health Records.• Lack of health treatment continuity once

a person is released to the free community.

Vision Shift

• Old Vision “We save money because we skip the ambulance and bring them directly to the morgue” Diane Jackson.

Privatizing State Prisons. (n.d.). Retrieved from https://www.seanc.org/files/4913/3961/6270/Privatizing_state_prison_report.pdf

– Medications not properly administered– Medical files are not consistently maintained– Sick calls are poorly maintained– Annual health exams not maintained– Poor staff training or not documented– No performance indicators for contract

renewals

IMS An Affordable Solution

– Data integrator, uses dashboards for tracking of all transactions, including fax, emails, external transmissions.

– Programmable to include performance indicators and balanced scorecards.

– Data transmitter to internal and external entities including EHR, coding and billing information.

– Capable of generating alerts, reports, and communicate with hospitals, pharmacies, and government agencies.

Opportunities

• To provide efficient and safe high quality service.• To deliver patient centered treatment• To implement EHR• To be compliant with ACA, HITECH, and HIPAA.• To deliver a coordinated, efficient and

sustainable care to patients.• To develop Health IT as bridge between prisons

and communities.• To focus on HR by providing and documenting

training, and by providing tools and standards for critical decision making in the filed.

Market AssessmentTable 1 IMS Critical Success Factors

External Issues Competitor Strengths and Weaknesses

Critical Success Factors

Highly Regulated Market – HIPAA, PCI, ACA, Etc.

S – Competitors have experience in the market.

Understand and transmit the capabilities of IMS, its adaptability and security.

High number of mergers and acquisitions within the industry.

W – Competitors have long lead times; systems are not easily adaptable.

IMS is an adaptable system, it integrates with legacy and new systems with key-on; key –off capabilities.

High pressure to reduce costs.

W – All products are expensive, predominantly during the interphase development and integration.

IMS has a proven track record of cost and complexity reduction.

Focus on Data Integrity and Data security.

W – HCO’s have not been particular strong on this field; their vendors are just starting to enhance information security on their products.

IMS has worked successfully on the banking industry for many years, its information security is one of the strengths of the system.

High demand for immediate communication.

W – Although, there are many “independent” systems are very good in their communication and reposting capabilities, they do not necessarily are a central depository of information.

IMS acts a center of information

Financial Assessment

Financial AssessmentYr 0 Yr 1 Yr 2 Yr 3 Yr 4 Yr 5

Outflows - Investment

(20,000.00)

(30,000.00)

(30,000.00)

(30,000.00)

(30,000.00)

(30,000.00)

Inflows Savings from a Single LawSuit

          1,200,000.00

Inflows Savings from implementing IMS

  1,078,500.00

2,696,250.00

5,392,500.00

7,010,250.00

10,785,000.00

Cash Flow (20,000.00)

1,048,500.00

2,666,250.00

5,362,500.00

6,980,250.00

11,955,000.00

NPV: $17,596,671.75

IRR: 5394%

SWOT IMS for CHC

• Adaptability• Focused on

Individual Needs

• Low Transaction Cost

• Short Implementation time

• Customer Service

• Cash Flow• Capital Cost• Unknown

Brand• Internal Cost

of unscheduled maintenance

• Medicare & Medicaid

• Demand for immediate information

• Cost Reduction

• Privacy• EHR

• Barriers to Entry

• Big competitors as IBM

• Cost Fixing• In House

programs

• Experience• Implementation• Flexibility• High value, Low

cost• Reports• Adaptability

WeaknessesStrengths Opportunities Threats CSF

Conclusion

• IMS can help CHC to improve quality of service, classify treatments, generate alerts, integrate remote and variable operations.

• IMS will reduce operational costs and complexity.• IMS will help to reduce costs associated with

fines, litigations, and help to maintain contracts.• IMS will help CHC to place patient first.• IMS can help to reduce HR stressors. • IMS can become the bridge for patients to

integrate to community health.

Questions…?

About the Impact of Information Data Integrators in the US Correctional Health System

References

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problems-with-privatized-correctional-healthcare/

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Closing the Books. (n.d.). Retrieved from

http://www.inthepublicinterest.org/wp-content/uploads/In_the_Public_Interest_Closing_the_Books.pdf

Corepoint. (n.d.). Retrieved from https://corepointhealth.com/solutions

Cowman, A., & Elizabeth, W. (2013 Vol 23 No 3). Patient and Public Involvement in Prison Health Care. Primary Health Care,

26-31.

ECS Financials. (n.d.). Retrieved from http://www.dmoz.org/search?q=ecs+financials&cat=all&all=no

Financials, E. (n.d.). Retrieved from http://www.ecsfin.com/

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Setting. American Journal of of Public Health, 805.

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Lousy Care in County Jails. (n.d.). Retrieved from http://Turn-Over at Corizons. (n.d.). Retrieved from

http://www.floridabulldog.org/2013/10/sudden-turnover-at-the-top-financial-downgrade-raise-flags-about-state-prison-provider-

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Williams, B., Goodwin, J., Baillargeon, J., Ahalt, C., & Walter, L. (2012 Vol 60 No 6). Addressing the Aging Crisis in U.S. Criminal

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