Correctional Managed Health Care. Michael Vasquenza, BS Kirsten Shea, MBA
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1 Correctional Managed Health Care Michael Vasquenza, BS Kirsten Shea, MBA
2 NO CONFLICTS OF INTEREST
3 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 CT is 1 of 6 states t with an integrated t jail and prison system. t 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 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) t Discharge Planning
6 Facility Inmate Mental Health Medical Population Bridgeport Brooklyn Cheshirehi Corrigan Enfield Garner Half Way House Hartford Hospital Care Manson MacDougall New Haven Niantic Annex Northern Osborn Radgowski Robinson Walker Willard/Cy York Totals: Census (2/1/2013)
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8 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
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11 Foundation outlined in 2009 RFP Funding challenges DOC RFP - Offender Management Information System (OMIS) Health care module
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13 No Money No EMR
14 Develop Alternative Strategy Establish Organizational Focus Areas Identify customers s Consolidate/centralize data Statistics/Trends/Research
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16 Managerial / Operational applications Disseminating Clinical Information Optimizing Resources Discover Trends / Research
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18 Demographics Name Number Age Date of Birth Last Address Sex SSN Religion Facility Housing Code Veteran Status Sentencing Bond Status Release Date HWH Hold Date HWH Eligible ibl Detainer DR Tickets Classification Medical Classification MH Classification Medical sub codes MH sub codes Sex Treatment codes Disciplinary history (tickets and classification of tickets) Infectious Diseases TB Status S/S screenings TST planted TST read TST result CXR History TB Indicated CXR Result TB Indicated Exposure History Isolation History Sputum Cultures Claims positive history Adverse Reaction to Medications Communicable Disease Diagnosis Date of Dx Comment on disease HIV Risk Factors HIV Confirmation - By HIV Confirmation - Date Living Will Test History (both community and CMHC records) ex: CD4, HCV, HIV-RNA, etc.. Exam History ex: CXR, PE Vaccination history Problem list details various categories Hep C Treatment dates 2 vs 3 Dug Regime Distinctions Mental Status Evaluations Signs/Symptom tracking Medication adjustments Treatment outcome
19 Interoperability Meaningful Use Health Information Exchanges Continuity of Care Document (CCDs)
20 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
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22 Scheduling Application W10 Application (discharge planning) Infectious Diseases
23 340b Federal Program Implement process by which doctors see patients Develop simple InfoPath form to retrieve data Provide reports to assure accountability, follow-up
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25 340b Yearly Savings $2,500, $2,000, $1,500, $1,000, $500, $- FY 2010 FY 2011 FY 2012
26 Simple example: Medication costs Provide data! Data available via pharmacies/vendors share it! Educate physicians
27 Example: START NOW Objective variables: Disciplinary tickets Inpatient admissions Security score modifications Recidivism
28
29 Contact t Information: Michael Vasquenza, BS [email protected] Kirsten Shea, MBA [email protected]
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