Addressing Data Sharing Barriers for Care Coordination from Jail to Community
Poor interoperability and fragmented care systems impede data sharing for the care coordination of individuals from jail to the community.
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By - Jails can provide opportunities to diagnose and treat individuals for HIV. However, supporting care coordination for formerly incarcerated individuals upon reentry into the community can be difficult due to data sharing challenges.
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Current CDC guidelines for HIV care post-release recommend providing individuals with a 30-day supply of their HIV medication and an appointment with a community provider within 30 days where the provider has access to the patient's carceral health record.
Following these guidelines is challenging for jail providers because they cannot always predict when someone will be released, especially if the individual is pretrial, according to a Tufts University study that evaluated the HIV care transition processes at a Massachusetts jail.
"There needs to be time to get the medication ordered and make that appointment with a community provider," Kim Dong, DrPH, MS, RD, co-author of the study, explained in an interview with Healthcare Strategies. "That piece of information is lacking."
"Within the jails, the case management team would know when someone's being released, but through what they thought were HIPAA issues, they would not be able to share release dates with the health services team that coordinates pre-release care," explained Dong, who serves as an assistant professor in the Department of Public Health and Community Medicine at Tufts University School of Medicine.
Further, patient health data is siloed between carceral record systems and EHRs, so sharing patient records presents interoperability challenges.
"The type of electronic health record that the health services unit has is different than what the case management team has," she said. "Those two systems aren't speaking to each other."
Through a quality improvement evaluation, the research team created a release planning checklist to help ensure that an individual leaves jail with a 30-day supply of HIV medication and an appointment with a community provider within 30 days of release.
"There needs to be this transfer and sharing of information to ensure smooth care for these individuals, not only for their health but additionally for the importance of the community," Dong emphasized. "It has big public health implications."
Jail systems in states like Texas, Florida, and elsewhere have been updating their EHR systems in light of data challenges.
