Technology Changes Chronic Disease Health Care
By Sarah Etter, News Reporter
Diabetes, asthma and hypertension are all diseases that require constant care, attention and check-ups – and in corrections health care, they have been especially difficult diseases to manage in the inmate population. In an effort to improve health care treatment and response, the Wyoming Department of Corrections (DOC) recently traded in its paper records for an electronic registry, created its health care provider, called the Chronic Care Tracking System (CCTS).
CCTS, which includes inmates who suffer from chronic diseases, was recently launched as a pilot program at Wyoming corrections facilities – and practitioners are pleased with the results so far.
“We’ve been exploring disease registry options for a long time now. We feel like this type of system helps with our main objective as providers: to reduce variability in treatment and to quantify what we do daily,” says Carl Keldie, Corporate Medical Director for Prison Health Services. “The registry gives practitioners feedback, prompts and reminders to ensure that every inmate is receiving care. This web-based disease registry identifies inmates in the population that are suffering from, for example, diabetes – and helps us focus in on that particular population.”
The CCTS was developed to reduce inconsistencies within corrections health care. Although the system is currently in the beta-testing phase, it could potentially change corrections health care across America.
“It’s a comprehensive system in that it will gather information for each visit an inmate makes, and track that information over time,” Keldie explains. “You don’t need to go back through a medical record to see how well a diabetic has been controlled medically over a year. You will have all of that [information] at your fingertips.”
The system provides electronic medical records for each inmate, prompts to remind practitioners about necessary treatment, and also measures the quality of health care each inmate receives.
“This system identifies who in the inmate population has a disease,” Keldie says. “Any time we use this system, we will have a registry of every inmate with that particular disease in an entire facility.”
Cutting Down on Mistakes
The CCTS was developed with a focus on identification, efficiency, outcome, prompts and outreach activity. By covering these five key areas, the CCTS helps practitioners to give each inmate the best care possible. And, according to Keldie, focusing on efficiency is one of the cornerstones of this new technology.
“Efficiency is a binary answer within this system,” Keldie says. “You either did the procedure or you didn’t. So when you’re looking at eye exams for diabetics, you know who either had one, or who didn’t. No middle ground.”
A focus on outcome is also important.
Keldie explains that the efficiency focus in CCTS does not say much about quality – so an outcome feature was developed to address that issue. The outcome feature specifically focuses on how well a practitioner is performing – by looking at the overall treatment of inmates with a specific disease throughout a facility. For instance, if a doctor has not completed an annual check-up for inmates with hypertension, the CCTS will report that information.
Prompts are also an important part of the electronic disease registry.
“These disease registries ask specific questions and require specific data,” Keldie says. “By recording medical information and procedures, the system will prompt the doctor with reminders, and that way they don’t have to remember every single process.”
Keldie adds that the CCTS was developed to prompt practitioners for certain essential procedures only, rather than every single procedure.
“Let’s say that you’re looking at the diabetic population in a facility; if a doctor is taking care of diabetics and the disease registry tells him that he’s only given 70 percent of his diabetic patients an eye exam, that doctor will know what needs to be done," Keldie says.
By ensuring that the prompts only provide the most necessary reminders, CCST helps to reduce time, minimize mistakes and ensure quality health care for chronic disease.
"There are certain things that we expect to be done for chronic diseases - but we also cannot have textbooks of information in each record," he says.
And by also implementing an outreach activity feature in the system, practitioners can keep an eye on preventative medicine.
”Outreach activity is a dimension of the system that indicates when it’s time, for example, to give an annual influenza vaccine,” Keldie says. “You can identify and track which diabetics have received their flu shot prior to flu season and then ensure that your population of diabetics are prepared.”
User-Friendly Interface
Additionally, Keldie says that the system is user-friendly, which also makes it easy to implement.
“One of the driving themes for this tool during production was to make it exactly that – a tool,” Keldie says. “This is a tool that a physician can use to query data, receive certain data and have more information. We didn’t want them to turn on the computer to be inundated with problems accessing the material.”
By providing a user-friendly chronic disease registry, Wyoming hopes to set the pace for the future of corrections health care. By eliminating the need for manual records, providing more effective health care and ensuring quality practices, Keldie believes that other states will soon adopt this type of technology.
“Basically, this is continuous quality improvement,” Keldie says. “This is a much more accurate tool and we’re rolling this technology out one disease at a time. I’m confident, based on current medical literature, that this will work – we need to lead our staff and providers to using a new piece of education technology in health care.”
From corrections.com Dec. 2005
