This spring, we’ll release “Innovating Michigan Healthcare: Lessons from Funding Technology in Health Since 2015,” an in-depth report on how the Health Fund is supporting technology-based projects. Our series “Tech Tuesdays” reveals some of our stories from the field—examples of Health Fund grantees incorporating technology in noteworthy and effective ways.
Washtenaw County Community Mental Health
Correctional Care Integration Project
2016 Special Projects and Emerging Ideas Grant Round
Children in the correctional system are a hard-to-reach and marginalized population in Michigan’s health landscape. Lack of coordination with health systems exacerbates the health dilemmas facing this group, and health initiatives serving this population are relatively scarce. Due in part to these inefficiencies, children and adolescents in the correctional system exhibit disproportionate prevalence of psychiatric illnesses, substance use disorders, and chronic disease. In other words, the obstacles that prevent corrections systems from storing and exchanging health information with external caregivers efficiently have profound consequences for this population’s health.
In 2016, Washtenaw County Community Mental Health’s (WCCMH) Correctional Care Integration Project (CCIP) sought to improve health outcomes by integrating a Health Information Exchange (HIE) into adult and youth correctional facilities in Washtenaw County. To successfully implement the HIE, WCCMH had to bring on board a variety of stakeholders throughout Washtenaw county, who in turn had to amend their existing workflows.
In order to understand how their target population’s health information was stored and transferred using existing processes, WCCMH worked with Altarum Institute’s Michigan Center for Effective IT Adoption (M-CEITA) to conduct a workflow analysis at the program’s outset. Changing workflows is a delicate process even in traditional settings, and integrating an HIE into a correctional facility with no centralized location for patient data raises additional obstacles. This meant conducting the workflow analysis prior to implementation was critical to achieving buy-in from clinicians, law enforcement, and all other involved stakeholders.
In addition to having to tailor each stakeholder’s workflow to account for integrating a new HIE, the electronic health records (EHRs) used by providers presented an additional obstacle. Since Washtenaw County’s providers used different EHRs from one another, WCCMH had to work with four different vendors whose software was in place at behavioral and physical health centers in the target region. Building on established partnerships and relationships meant that from the start, vendors understood the community, organizations, and systems in which they’d be working.
Specifically, WCCMH partnered with Great Lakes Health Connect to integrate the HIE, and with Correct Care Solutions to revise existing processes at Washtenaw’s corrections system. These dual efforts enabled more efficient storage and exchange of health information belonging to children and adolescents in the corrections system. Additionally, allowing electronic management of consents to exchange behavioral health information was key to establishing continuity of care within the corrections system.
Revisions to each stakeholder’s workflow along the care continuum allowed for a more centralized, fluid coordination of patient data, resulting in better identification of medication-seeking behaviors and individuals with duplicate prescriptions. These revisions directly resulted in more effective care coordination for this hard-to-reach population.
CCIP’s success exemplifies how technology can correct inefficiencies even in complex systems that involve multiple partners with potentially divergent interests. It also demonstrates certain technology fixes have built-in sustainability—fixing the system once pays dividends for years. This is especially relevant for underserved populations like incarcerated individuals, who might also see the greatest benefit from such a simple fix.