Health Information Management Operational Assessment

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Receivership’s Mission Reduce unnecessary morbidity and mortality and protect public health by providing patient-inmates timely access to safe, effective and efficient medical care, and coordinate the delivery of medical care with mental health, dental and disability programs. 10
GLOBAL SUMMARY ASSESSMENT This portion of our report focuses on each of the functional elements of Health Records that, if consistently standardized, would promote more effective and efficient health information management thereby promoting a constitutional level of care. The following findings have universal applicability across the California Department of Corrections and Rehabilitation (CDCR) institutions. As such, they represent the current environment of Health Information Management (HIM) upon which remediation will be based. While we acknowledge there may be institution-specific variations to our global assessment findings, we are confident these global findings will form a basis for remediation planning. The detailed remediation plan will adjust for site specific differences. Global Summary Assessment Summary of Assessment Findings AREA Human Resources Deficiency in leadership FINDING Inadequate staffing Procedural Poor health record availability Poor quality of health record content Lack of current policies and procedures Loose filing significantly exceeds goal Technology Approach Lack of chart tracking Lack of release of information automation (ROI) Lack of encoding and abstracting software Physical Infrastructure Transportation Suboptimal use of existing space Inefficient and unsecured record transportation 11
Page 1 and 2: California Prison Health Care Recei
Page 3 and 4: TABLE OF CONTENTS Executive Summary
Page 5 and 6: EXECUTIVE SUMMARY This report segme
Page 7 and 8: IMPACT STATEMENT The majority of th
Page 9 and 10: Assessment Process The comprehensiv
Page 11 and 12: Meanwhile, HIM has been allowed to
Page 13: assessment Findings Use of Global A
Page 17 and 18: Inadequate Staffing----------------
Page 19 and 20: Procedural Poor Health Record Avail
Page 21 and 22: Lack of Current Policies and Proced
Page 23 and 24: Loose Filing Backlogs Significantly
Page 25 and 26: Technology Approach Lack of Chart T
Page 27 and 28: Lack of Release of Information (ROI
Page 29 and 30: Implication Without coding and abst
Page 31 and 32: Implication The inadequate HIM spac

Health Information Management Operational Assessment

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