Today's world is one of computer networks and mandatory connectivity in nearly every aspect of one's personal and professional life, even in medical offices. Most hospitals and private practices already have implemented the use of electronic medical records in order to improve efficiency and portability of patient health information. Correctional facilities, however, have often hesitated to embrace ideologies and practices of the free world. The use of computer technology is no exception. This reluctance is understandable when one considers the many challenges involved in implementing computer programs in the correctional environment.
Security is always the first consideration. In order to run an electronic medical record (EMR), computer hardware is required. Computer hardware in the medical unit can be used as a weapon or become a target for theft and vandalism if it falls into the hands of an inmate or juvenile offender. Computers may allow access to the outside world by offenders who want to acquire contraband or make illegal contacts. Early software systems were often expensive and not suitable to corrections because they did not consider complex medication administration requirements or sick call procedures. While there has been improvement in correctional applicability and some reduction in cost, it is still challenging to determine which software system is most advantageous for purchase. Since most correctional facilities are affiliated with government entities, the bidding process can be slow and delay making acquisitions. It is possible that the system could be obsolete by the time the process is complete.
The other dilemma for correctional facilities is the need for purchasing security and administrative software, balanced with the need to purchase programs to implement an EMR. These distinct programs are unique, but very interdependent on one another for efficient operation of the facility. Once a system is identified and purchased, the next challenge is implementation. It has become much easier now to overcome the training hurdle for computer use, simply because the general population is more computer literate now than even a few years ago. Specialized training will still be required in order to maximize success. Access to 24-hour technical support is essential for systems operating in a correctional setting.
At least three state juvenile correctional systems have been successful in creating an electronic medical record that is integrated within the administrative and security functions of their computer systems. The Texas Youth Commission, the Arizona Department of Juvenile Corrections and the Georgia Department of Juvenile Justice all utilize EMRs. The Georgia Department of Juvenile Justice (DJJ) impetus for creation of its EMR began in 1998 as a result of a memorandum of agreement (MOU) between DJJ and the Department of Justice. The MOU required a system of transfer of medical records across 24 secure facilities statewide.
The most efficient way to accomplish this requirement was the development of an EMR. A new Office of Technology and Information …