The Electronic Health Records System Project: Making a Positive Impact on California’s Incarcerated

How was the California Correctional Health Care Services (CCHCS), one of the country’s largest and most dynamic healthcare organizations, able to shed its reliance on archaic manual paper patient files? Simple, it adopted the Electronic Health Records System (EHRS).

Recently, the California Department of Technology (CDT), which is responsible for state IT project oversight, released its final Independent Project Oversight Report for the EHRS project, a fully integrated health electronic record system managed by CCHCS. CDT expressed that after 4 years, the EHRS project is complete and providing business value to CCHCS.

All components of the prison health care system – medical, mental health and dental – are integrated within EHRS, making it a one-stop shop for patient information. This is where EHRS shines. While it is a commercial-off-the-shelf solution configured to improve quality, safety and efficiency of patient care in a correctional setting, the sheer volume of information EHRS handles is impressive.

The system supports more than 116,000 patients and 9 million daily medical record transactions for an average of 9,552 daily users. The beefy project integrated 5,000 new wireless devices and configured over 30,000 existing devices that needed to communicate with EHRS, which allowed providers to manage patient care based on real-time data from a single integrated system. It linked all of CDCR’s 35 prison institutions, several headquarters locations and a central fill pharmacy.

Getting started required converting a massive volume of paper health care files into digital documents. The files were located at various California correctional institutions and the centralized health records center. In 2011, CCHCS began scanning hundreds of thousands of paper patient records, totaling millions of pages, into electronic documents and storing them in a central database. The electronic Unit Health Record (eUHR) system was CCHCS’ solution for a health care records database. With eUHR in place, CCHCS installed network drops and miles of fiber cable into all of its prison institutions, providing hardwire and wireless network access to more than 10 thousand computers. That made it possible for all sites to scan patient records. However, CCHCS was still using paper forms and scanning them into a collection of electronic files. By 2012, the agency determined it would transition to a fully integrated electronic system; although, the scanning continued. To date, about 94 million records have been scanned.

CCHCS Director of Information Technology and Chief Information Officer Cheryl Larson stressed the importance of collaboration in the success of the project. “Working closely with CDT, CCHCS successfully implemented a fully integrated health care technology system to deliver effective medical, dental and mental health services to California’s prison population.”

The implementation of EHRS led CCHCS to receive Stage 6 certification by the Healthcare Information and Management Systems Society for each of the 35 institutions. Stage 6 denotes that an organization delivers high-quality patient care with an interoperable electronic health record in place. Only about 40 percent of the acute U.S. and 22 percent of the ambulatory U.S. organizations attain Stage 6 recognition. CCHCS is the first correctional organization or facility in the U.S. to reach this level.