Improving Processes and Health Outcomes at State Correctional Institutions Case Studies

California Correctional Health Care Services (CCHCS) was named a 2018 HIMSS Davies Enterprise Award recipient for leveraging the value of health information and technology to improve outcomes. CCHCS provides the full range of healthcare services to more than 125,000 adult offenders housing in 35 institutions across the state of California. The three award-winning case studies cover implementing patient registries to improve liver disease and influenza outcomes, as well as automating a clinical risk classification system to appropriately place high-risk patients.

Case Studies

1. Improving Advanced Liver Disease Outcomes Using Patient Registries

Advanced Liver Disease (cirrhosis and hepatocellular carcinoma) has been a major contributor of morbidity and mortality among the CCHS population over the past decade. As part of a statewide improvement initiative, CCHCS leveraged healthcare information technology to create a patient registry and associated performance expectations. This improvement initiative resulted in a 27% improvement in the performance measures in under two years, with sustained improvement for more than a year. Along with improved patient care performance metrics, CCHCS saw a significant decrease in the age-adjusted mortality from advanced liver disease to levels consistent with the rates published by the Centers for Disease Control and Prevention.

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2. Automating a Clinical Risk Classification System

CCHCS created a clinical risk classification system to inform placement of patients to the most appropriate facility to best serve their needs. The original process was a manual, paper-based process resulting in inappropriate placement of patients due to inconsistent application of the clinical risk rules by multiple providers and clinical risks not always reflecting the most recent health-related information impacting clinical risk. To improve the accuracy, reliability, and timeliness of clinical risk, CCHCS leveraged information technology solutions to automate the clinical risk classification system, resulting in a 18% improvement in the appropriate placement, among many other outstanding results.

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3. Improving Influenza Vaccination Rates Using Patient Registries

Influenza is a significant threat to the vulnerable population at CCHCS, as they have significant morbidity, are highly migratory, and live in close quarters. During the 2016-2017 influenza season, only 3/4 of the population were offered the influenza vaccine and 38% actually received the vaccine. By leveraging healthcare information technology, CCHCS was able to create an influenza vaccination registry to track patients as they move through our system and monitor vaccination offerings and administration performance through the state. Additionally, more than 95% were offered the influenza vaccine during the 2016-2017 influenza season and 46% received the vaccine. This improved performance placed CCHCS on par with national rates published by the National Commission for Quality Assurance’s Healthcare Effectiveness Data Information Set for 2016.

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