A troubled county jail, where hundreds of lawsuits have stemmed from mistakes in managing the inmates' health information, would be a perfect testing ground for electronic medical records, the Arizona Republic reports in a two-part special report. But Maricopa County officials have not acted on repeated recommendations to implement such a system, "even when faced with hundreds of lawsuits and the loss of accreditation for CHS (Correctional Health Services) operations."
The inmates have often not been convicted of crimes, arrive at the rate of about 350 a day, often use drugs and have psychiatric disorders. The paper adds: "They're also the only people in the country with a constitutional right to health care, and it's the county's job to provide it." In many cases, the inmates have not seen a doctor in years despite problems with chronic diseases like diabetes, the Republic reports. And the jail "still relies on paper files and an electronic database designed for jailers, not doctors, to track the physical and mental ailments of its 10,000 inmates" across six facilities in the county.
The Republic relays the story of Deborah Braillard, an insulin-dependent diabetic, who was jailed for five days, gliding in and out of consciousness, a condition guards assumed was related to drug withdrawal, before being taken to a hospital where she died. Paper records from a previous visit listed her condition, but the staff didn't check them. "An electronic-medical-record system provides a central database that can be designed to hold any kind of information," the Republic reports. "Files are available to health-care workers across the institution" (Hensley and Wingett, 6/1).