The latest plan to overhaul California's state prison healthcare system calls for standardizing business processes first—then deploying new technology—across all 33 penitentiaries.
In 2005, a federal judge seized control of the system from California, appointing Bob Sillen, a career healthcare administrator, to turn it around. Sillen was fired in January, criticized by some for moving too slowly. Clark Kelso, a lawyer and former California state CIO who now leads the project, plans an "aggressive" work schedule to return the prison medical system to state control.
The goal is to create a healthcare system that both meets constitutional standards and can be managed and maintained by the state. U.S. District Court Judge Thelton Henderson has ruled that medical care of inmates in California is so "deplorable" that it violates Eighth Amendment prohibitions of cruel and unusual punishment. Preventable deaths among inmates occur weekly, court reviews have determined.
"IT by itself isn't going to solve anything in California's prison healthcare system," Kelso acknowledges. Standardizing processes such as how nurses, doctors and corrections officers respond to inmates' health emergencies is the first step toward reducing "unnecessary" deaths. "We have to reach out to each institution and try to build from the ground up a new way of doing business."
Common Procedures and Software
Yet creating common procedures in areas such as the intake of new inmates, or the management of medications prescribed for chronic illnesses, will also allow the prisons to use common software and networks for those tasks, he says. In general, Kelso's IT plan accelerates deployment of many projects that are already underway. The plan includes:
- Beginning in July, expansion of telemedicine to give inmates access to medical specialists at area hospitals.
- By February 2009, establishment of a central pharmacy serving all prisons. The pharmacy would use Maxor's GuardianRx pharmaceutical management application, which is already installed in five prisons, to track prescriptions systemwide.
- By July 2009, deployment of a central database for inmate medical records, including treatment histories and lab results. Kelso says he expects to buy the database from Oracle and award a contract to an integrator in the next few months.
The plan also talks about construction of new facilities at each prison, which will not be completed until July 2013.
As for when he will return the system to state control, Kelso won't estimate a date. "I don't know how quickly we will have changes take hold. It will take as long as it takes," he says. "I need to be able to demonstrate that we've made systemic changes in the way we provide care for patient inmates and that those changes result in fewer preventable deaths and a healthier prison population. "I've got to be able to show that. Otherwise the court won't have confidence that we changed anything."