After Early Success, Office of Behavioral Health Expands CORHIO Partnership to Bring HIE to More Colorado Jails

Several Colorado jails are seeing gains in improving the health outcomes of incarcerated individuals with the help of real-time access to medical information through CORHIO.

When an individual is booked at a municipal or county jail, their medical records don’t automatically accompany them. Typically, there’s a scramble to piece together a medical history from multiple sources, including the inmate, which is often time consuming. Relying on an inmate to provide a complete health history – including acute and chronic health conditions and current medication use – is, at best, not completely reliable.

Even though individuals can be booked at any hour, in some rural or smaller jails, there’s not always a medical staff member on site to conduct an intake exam. For this population, a delay in care could result in serious, even life-threatening consequences, not to mention critical missed opportunities to identify and divert people with behavioral health disorders to treatment settings.

How HIE came to Colorado jails

The passage of Senate bill 17-019 in 2017 ultimately led to more focus and funding towards improving medication consistency solutions in county and municipal jails and a partnership with health information exchange (HIE). 

In April 2019, the Colorado Department of Human Services Office of Behavioral Health tapped into state funding sources to engage with CORHIO and Quality Health Network in a pilot project to improve data sharing in a handful of municipal and county jails. The hope was that improved access to and exchange of health information would translate to better behavioral and physical health outcomes for individuals in the criminal justice system and eventually lower recidivism rates.  

“We called it a pilot because it took a lot of work to get people connected to the HIE and to support our sheriffs and clinical staff with thinking through when they screen individuals in a jail and how to treat patients with behavioral health disorders,” says Camile Harding, Division Director of Community Behavioral Health in the Office of Behavioral Health.

She adds, “We shouldn’t keep an individual in jail if maybe instead they need mental health services. We want sheriffs to be able to do a warm handoff to community providers and criminal justice involved organizations.”

Coordinating care with comprehensive view

Currently 10 jails in several areas of Colorado (with more onboarding soon) are integrated with CORHIO's PatientCare 360 secure Web portal to help coordinate care for inmates and learn their patient histories at intake. 

“[PatientCare 360] allows the staff to meet the needs of the inmate quicker as they won’t have to spend hours verifying information,” says Brenda Connot, LPN, health services administrator at the City and County of Broomfield Police Department. 

Feedback from jails using PatientCare 360 has been overwhelmingly positive. Early results have been so promising that OBH contracted with CORHIO to bring a half dozen more jails online in 2021 using funding earmarked for mental health expansion.

Beyond intake, HIE access is valuable throughout incarceration and for discharge planning. Facilities report using PatientCare 360 to determine if an inmate has a primary care provider and to help coordinate care after discharge. 

“To support individuals in transitioning back to the community, you need a comprehensive look at the services,” Harding says. “HIEs are really foundational to that – you need the right information to treat individuals.”

The benefit of COVID-19 insights

When COVID-19 hit Colorado in March, some jails relied on CORHIO’s COVID-19 Lab Notifications to keep tabs on inmates who require long-term hospital stays and check for any COVID-19 test results to better prepare for their return.

“I’ve had multiple commissioned supervisors come up to me completely unsolicited, but just in talking to the medical team, they’ve approached me and said, ‘I had no idea what an added resource CORHIO would be until COVID-19,’” says Carl Anderson, RN, administrative manager at the Arapahoe County Jail. “I’m passionate about CORHIO but for even the sworn members of our agency to pick up on the importance of it – I think that speaks volumes.”

Medication savings and future expansion

An unanticipated outcome of the CORHIO partnership may be the most valuable of all so far; jails are using CORHIO data to look for trends in the medication needs of inmates (particularly psychotropic drugs). The ability to order the right medications in bulk and leverage state pricing agreements has resulted in significant cost savings. 

As far as next steps, the Office of Behavioral Health is working to increase bi-directional exchange of medical information between jails, add more telehealth capabilities to help jails with staffing, and scale the program so all Colorado jails have HIE access in the future. The office is also planning to add filled medication information to the data exchange so jail staff can more easily track down an individual’s treatment history.

“We still have a long way to go, but this is a really important project, and I love it,” Harding says.

Shawn Laughlin, Support Services Commander of the Broomfield Police Detention Center, called the project a “game changer.”