No EMR? No Money ? No Problem…….

1. Correctional Managed Health Care No EMR? No Money ? No Problem……. Michael Vasquenza, BS Kirsten Shea, MBA

2. Disclosures • NO CONFLICTS OF INTEREST

3. Learning Objectives • Participants will understand the current challenges, specifically those in CT, of disseminating health information across departments, across facilities, and across agencies in the absence of an EMR. • Participants will understand cost effective alternatives to an EMR as demonstrated by CMHC’s Information Technology solutions. • Participants will understand the importance of developing data systems which are interoperable and easily transferable to ancillary programs and applications.

4. State of Connecticut Department of Correction • CT is 1 of 6 states with an integrated jail and prison system. • 20% of admissions require prompt medical or mental health intervention • Hartford Correctional Center (jail) averages > 45 intakes daily • 26,143 annual admissions, each with screening requirements • Medical and psychiatric disease prevalence rates far greater than community • 19% active Mental Health treatment • 24% active Medical treatment • 60% on medications

5. State of Connecticut Department of Correction • Cost of global healthcare per inmate per year (both genders) was $4,735 (FY 2012) • 60% of inmates on medications • Specialty Care (on-site/off-site appointments) • Discharge Planning

6. CT Department of Correction Census (2/1/2013)

7. Correctional Managed Health CareOperational Model

8. Corrections and Technology • Challenges • Population Needs in the context of budget reductions • Pharmacy services • Aging population • Legal obligations • Logistics specific to Correctional Institutions / Building Infrastructure • Space and accompanying environment • Organizational Structure / Ownership

11. EMR Opportunities • Foundation outlined in 2009 – RFP • Funding challenges • DOC RFP - Offender Management Information System (OMIS) • Health care module

12. The Vendors

13. Dead End No Money – No EMR

14. No Problem Develop Alternative Strategy • Establish Organizational Focus Areas • Identify customers • Consolidate/centralize data • Statistics/Trends/Research

16. Applying Data • Managerial / Operational applications • Disseminating Clinical Information • Optimizing Resources • Discover Trends / Research

18. Data!

19. Storing Data • Interoperability • Meaningful Use • Health Information Exchanges • Continuity of Care Document (CCDs)

20. Data for Management • Dashboards • Medical Census • Mental Health Census • Employee Overtime • UR Appt Completion Stats • Psychiatric Diagnoses • Current JDH Inpatient Census • 340b Patients to be Seen • Monthly Statistics: • Episodes Self-Injury • Suicide Attempts • Number Sick Call visits

21. Data for Clinicians

22. Sharing Clinical Information • Scheduling Application • W10 Application (discharge planning) • Infectious Diseases

23. Data for Efficiencies 340b Federal Program • Implement process by which doctors see patients • Develop simple InfoPath form to retrieve data • Provide reports to assure accountability, follow-up

24. Pharmacy – 340b

25. Pharmacy – 340b

26. Data to Optimize Resources Simple example: Medication costs • Provide data! • Data available via pharmacies/vendors…share it! • Educate physicians

27. Data for Research Example: START NOW Objective variables: • Disciplinary tickets • Inpatient admissions • Security score modifications • Recidivism

28. Wouldn’t it be nice???

29. Questions?? Contact Information: Michael Vasquenza, BS mvasquenza@uchc.edu Kirsten Shea, MBA kshea@uchc.edu