Electronic Health Records
Capital Project Name: Electronic Health Records
Location: Correctional Health Services
Total project cost: $6,178,217
Year completed: Ongoing
When Dr. Jeffrey Alvarez came to Maricopa County Correctional Health Services (CHS) in 2009, the information he needed was not always easy to find. It was a time of paper files faxed between county facilities, and daily phone calls to providers clarifying what was actually in those paper files.
“Our health staff did their very best, but they often had to see patients without access to a health record, or else they’d have to wait while someone scrambled to track down the charts at other facilities,” Alvarez remembers. He was bogged down in minutiae as well. “Let’s say I had 50 emails, and 25 were clinical in nature,” the CHS director says of his job of approving patient treatment plans. “Those 25 emails might have been what I had to work on all day. Now, I can go through those same 25 clinical emails in a matter of minutes."
He has the information he needs at his fingertips because of the county’s investment in an electronic health records system, which became fully operational in early 2014.
100,000 inmates every year depend on CHS to get them medications, treatments, and provider appointments. The electronic records system allows Dr. Alvarez and other CHS staff to log in and see hospital records for any patient who comes into the county jail system, no matter where they are.
“Moving to electronic health records allows Maricopa County to provide better personalized care, save staff time and money, and make more accurate records, resulting in fewer opportunities for mistakes,” said Supervisor Bill Gates, District 3. “The ability to search records electronically creates a more efficient business model and allows our correctional health staff to focus on treating patients, not paper.”
The screening inmates receive at intake is one example. CHS has been able to speed up the process and cut back on the number of clinicians needed to perform it. The new way of screening saves nursing staff an average of 610 hours monthly which equates to $23,790 saved each month, or $285,480 annually.
Some jobs have been reimagined as a result. Medical record staff (whose primary duty was scanning paper records) have been reassigned to clinic-based positions that help directly with patient care.
The electronic records system is even saving lives in cases where patients don’t want to divulge sensitive medical information, such as past suicide attempts or substance abuse.
“That happens all the time,” Dr. Alvarez explains. “They don’t want to say, ‘You know what? I was shooting heroin.’ But our nurses know. They say ‘He won’t tell me he’s on drugs, but I know he is because I see the record.’ So then we can go ahead and start withdrawal protocols.”
Quick access to records has allowed CHS to be more nimble and effective in addressing growing health issues in the community such as opioid dependency and mental illness.