eClinicalWorks EHR System at Rikers Island Correctional Health

Overview of Corizon Health

Corizon Health is the founder and leading provider of correctional healthcare in the United States. It is a corporation built on more than thirty-five years of innovation and expertise in the healthcare industry, having grown into the largest and most prominent care provider in its field. The mission statement of Corizon Health clearly outlines that it is a company which, over the years, has established itself on modernism and capability (Corizon Health Website, 2015). Its personnel, practices, and commitment to achievement through evidence-based medicine empower it to consistently meet and surpass client expectations. The core mission of Corizon Health is centered on patient safety. Health management in correctional healthcare facilities and prisons brings about quality inmate patient care in tandem with public safety, which are at the core of the company's mission (Corizon Health Website, 2015).

The main goals and objectives of Corizon Health are to provide client partners with high-quality healthcare and support services that will improve the health and safety of patients, decrease recidivism, and better the communities where the company lives and operates. Corizon Health's organizational culture encompasses a focus on open communication, integrity, accountability, and collaboration. These same objectives and goals provide the basis for the company's organizational dedication to a culture of patient safety. The company acknowledges excellence in patient safety as a journey rather than a destination, and strives at all times to improve the quality of the healthcare it delivers, with constant attention to safety, efficiency, and cost-effectiveness (Corizon Health Website, 2015).

eClinicalWorks System Currently in Use

eClinicalWorks (eCW) has emerged as a leader in medical software solutions. Its newly designed electronic health records software is top rated in customer satisfaction and usability. It enables healthcare providers the opportunity to deliver the highest quality care by placing customers and employees first. The system is designed for locating and storing records within the facility. Prior to eCW, Rikers Island was documenting patient information on paper. Therefore, when inmates left facilities, it was difficult to locate their records. In addition, when they were re-arrested, their old records could sometimes not be found. This computer system helps with continuity of care. Furthermore, the system can be accessed for the Bellevue Hospital prison ward, so if prisoners are hospitalized, their medical records can be retrieved and reviewed.

One of the challenges and downsides of the system currently in use is that it cannot be accessed from outside the facility on personal computers, due to HIPAA regulations. The practical implication of this is that if a staff member forgets to document or record information, he or she is forced to return to Rikers Island to obtain it. This wastes time and resources. More significantly, it can cause serious consequences when a patient in critical condition must wait for treatment due to the lack of accessibility to patient information.

One aspect of the system that works well is the ease with which users can engage with data and their patients. The eClinicalWorks system provides a secure communication link between nurses, physicians, and patients, and facilitates the management of patient health. For instance, users are able to access personal health records (PHR), review lab results, request refills of approved prescriptions, request referrals, and note dietary changes or important patient information.

User Needs Analysis

There are numerous users of the eClinicalWorks computer system in the provision of medical care at Rikers Island Correctional Facility. The following describes each user group and their specific needs.

There is a need to ensure that correct diets are administered to the right patients. For instance, if a certain drug is prescribed and certain foods are contraindicated, the system enables meal providers to ascertain the appropriate dietary procedures and confirm that the correct meal is administered. Similarly, if a patient is scheduled for surgery and must fast beforehand, the system ensures that no mix-up or error occurs. This also applies to post-operative diets and to inmates who are allergic to certain foods. The system facilitates awareness of which inmates must avoid certain meals.

Nurses are among the primary users of the computer system. They use the system for medication administration to different patients. For example, if a patient is to be administered medication three times a day, that information is entered into the system for nurses' reference. Nurses also use the system to update the medical records and information of inmates, which is essential for future treatment needs. Additionally, the eCW system provides nurses with valid access through a single tap of a secure card, eliminating the need to enter usernames and passwords repeatedly. This allows nurses to spend less time on the computer and more time providing direct nursing care — an approach consistent with Corizon Health's mission to promote both patient and employee satisfaction, thereby contributing to patient safety and improved healthcare outcomes.

Medical doctors must administer care to numerous inmates at Rikers Island Correctional Facility. The system supports several needs. Doctors are able to accurately record medical details of inmates to ensure correct diagnoses and appropriate treatment. The system also enables doctors to share patient data with nurses and the broader facility. Physicians can search and retrieve patient records efficiently. Given that the hospital is at some distance from the facility, a doctor can provide a medication note without needing to write paper orders each time. The use of the eCW system and standardized order sets helps eliminate handwriting inaccuracies that could otherwise lead to adverse patient events.

Correctional officers are primarily consumers of data from the system, though they may also be involved in monitoring data entry. The system is used to maintain summaries of disciplinary proceedings and their outcomes — for instance, transfers to alternative custody, hearings, and releases to parole.

The eCW system provides discharge planners with the ability to manage patient discharge processes. This includes a patient data repository capable of storing patient information, as well as a discharge planning module that can generate a planning interface for different users. Discharge planners use the system to facilitate the transfer or discharge of prisoners hospitalized at the Bellevue Hospital prison ward. They can also use the system to identify necessary post-discharge medical care options, match patients with appropriate care providers, and automatically send discharge requests to designated medical providers (Gerdin et al., 1997).

The computer system is employed for administrative functions by the institution's administration. It supports the summarization of annual activities in the form of program reports, including expenditures for personnel, facilities, and equipment. The system is also used to maintain up-to-date personnel records, including appointments, departures, assignments, and relieving of assignments. Day-to-day activities undertaken at the facility require the ongoing use of the computer system (Josi and Sechrest, 1998).

Conclusion

eClinicalWorks (eCW) has emerged as a leader in medical software solutions. Its newly designed electronic health records software is top rated in customer satisfaction and usability, enabling healthcare providers to deliver the highest quality care by placing customers and employees first. This paper evaluates eClinicalWorks' usability, practicality, and user feedback in the area of correctional health with regard to Corizon Health's mission, core values, and meaningful use. Corizon's mission of patient safety and awareness is best exemplified by its provision of resources to staff, officers, and inmates — which is precisely what eClinicalWorks provides to Rikers Island Correctional Facility.

The system supports continuity of care and can be accessed for the Bellevue Hospital prison ward, allowing medical records to be retrieved when prisoners are hospitalized. This ensures that patient safety is maintained across dietary requirements, post-discharge needs, and medication administration. Desired improvements to the system include greater mobility, multi-functional capabilities, and integration with cloud-based infrastructure to support more efficient and secure access to patient information.

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