MetroHealth System Goes To Jail To Improve Continuity Of Care - InformationWeek

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8/11/2015
08:06 AM
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MetroHealth System Goes To Jail To Improve Continuity Of Care

The MetroHealth System in Cleveland, Ohio was challenged to add a major facility while undergoing a radical enterprise software upgrade. Did they succeed?

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A charter to provide healthcare to a broad swath of a city's residents can mean taking services to unusual places -- the inside of a jail, for instance. That's where the MetroHealth System took its operation when a request came in from the Cleveland County Jail for a proposal to take over inmate healthcare services.

Mary Weir-Boylan, vice president of ambulatory operations, and Donald Reichert, vice president and associate CIO, were the executives who led MetroHealth's response to the request. InformationWeek interviewed the two recently in a joint phone call.

In the process of accommodating the jail's request, they said they realized new operational efficiencies across most of their organizational functions. Of course, doing so meant wholesale changes to the software on which the entire hospital system runs.

According to Weir-Boylan, Cleveland County Jail officials came to MetroHealth about three years ago asking for a proposal. Their timing coincided with a major software overhaul at the healthcare organization.

The scenario was simple, if somewhat daunting: The jail houses 26,000 to 30,000 inmates each year, which works out to around 150 to 200 each day. Each new inmate has to go through an intake process conducted by a healthcare professional. And thus begins the inmate's encounter with the healthcare system.

MetroHealth in Cleveland, Ohio

(Image: Courtesy of MetroHealth)

MetroHealth in Cleveland, Ohio

(Image: Courtesy of MetroHealth)

To make the overall heathcare processes at the facility go smoothly, Weir-Boylan said that they immediately saw the need for two changes. The first was a change to the physical infrastructure -- modern imaging and diagnostic equipment was necessary. The second change was in process: The jail was running its infirmary on paper records, and MetroHealth executives felt that a move to electronic health records would improve many things.

"We have Epic here at MetroHealth, and we really wanted to integrate into that system," said Weir-Boylan. "We wanted to be using it for outpatient services and medication, and use it from the hospital side so we could even track the inmates as they moved from cell to cell to make sure that their care delivery remained constant," she said. In addition, integration with the hospital's Epic system would make it easier to integrate the patient into the community's healthcare system after release. "When [inmates] get their healthcare on the outside, in the 'real world,' they most likely come to Metro anyway," Weir-Boylan explained.

The Cost Of Healthcare

Reichert said that better care for inmates was a primary goal of the project, but it wasn't the only one. "One of the things the county wanted to do was reduce their cost," he said. "When a prisoner came to have services at our facility, normally it would require two deputies plus a car for a minimum of four hours. That was their benchmark. We looked to eliminate all of that and the significant cost to the county, and provide ultimately better, more consistent care for the continuum of the patient's life in Cleveland."

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Cost savings came from more than merely eliminating travel and escort dollars, Weir-Boylan said. She pointed out that putting records into the Epic system ultimately saved time at the hospital and the jail. "The inmates are, unfortunately, not always one-timers. If they're 'frequent fliers' at the jail currently, they might give us fictitious names or fictitious histories, and intake would take five times as long,

[Story continues on Page 2: Piecing the puzzle together.]

Curtis Franklin Jr. is Senior Editor at Dark Reading. In this role he focuses on product and technology coverage for the publication. In addition he works on audio and video programming for Dark Reading and contributes to activities at Interop ITX, Black Hat, INsecurity, and ... View Full Bio
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Ariella
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Ariella,
User Rank: Author
8/11/2015 | 10:31:02 AM
healthcare in jail
Great title, Curtis! Also great topic. I recently heard a talk on this about such systems being educational about maintaining patients' health without increasing costs. 
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