Corrections Magazine

May 3, 2004 — Providing quality healthcare to jail systems can sometimes be tough. Offenders are continually flowing in and out of facilities, budgets are tight and doctors often work at jails part-time, splitting their hours with other jails or private practices.

Like many other providers, Dr. Abdul Jamaludeen, Medical Director of the Hampton City and Virginia Beach City Jails in Virginia, has his hands full treating and keeping track of inmates' medical issues. The PrimeCare Patient Management System Version Nine makes his life a little bit easier, though, by helping him to collect patient medical histories, diagnose inmate ailments and document their treatment courses.

"There are a lot of times when [jails] don't have a physician there very often, so using the PrimeCare system, you have the advantage of [taking a] patient history the same as if the doctor were present," said Jamaludeen, who has been using the system for nine years both in private practice and in corrections.

According to both Jamaludeen and Jeff Nelson, Executive Vice President for PrimeCare Systems, Inc., the system is a perfect fit for corrections, which is why OCG Technologies, PrimeCare's parent company, recently decided to market it to jails throughout the U.S.

"You have a market that is mandated [to] provide medical attention and, yet, they probably have more problems than regular society in that everything is budgeted and it's budgeted based upon the inmate population," Nelson said. "A lot of [the] time [jails] are not able to have as many medical staff as [they'd] like to have, so [they] wind up with a nurse [or] physician's assistant, not doctors, who are the first line [when an inmate has a medical problem]."

Questionnaires Lend Doctors a Helping Hand

The PrimeCare system was built for this exact circumstance--so that patients can be probed about their current and past medical problems even without a doctor in the room. When inmates complain of chest pain or a headache at one of Jamaludeen's jails, they first respond to one of PrimeCare's 200-plus, symptom-specific questionnaires.

"The questionnaires are based on a patient complaint. If the patient says 'I have chest pain,' then there is a chest pain questionnaire that asks the patient all of the questions that ordinarily a physician should or would ask," Jamaludeen said. "If the patient has a headache, then there's a headache questionnaire."

According to Nelson, the PrimeCare system is a tremendous aid to doctors because its questionnaires, which were developed by physicians, can elicit responses that will help them to properly diagnose patients.

"With our system, the inmate or the patient can be asked the questions for their shoulder pain [or] their head pain that the physician would ask if he had all the time in the world and a perfect memory," Nelson said. "There are two diagnoses that a doctor will always miss: the one he never heard about and the one that he doesn't ask a questions to make him think about."

Because PrimeCare's questionnaires are accessible via the Internet, patients outside of corrections are able to respond to them on their own. Inmates at the Hampton City and Virginia Beach City jails are prohibited from using computers, however, so the questionnaires are administered to them in paper-based form and then a medical staff member inputs the information into the computer.

Either way, though, the result is the same. The PrimeCare system processes the information and produces a report, featuring all of the questions to which that patient answered "yes," all of the significant negative responses and a list of the possible diagnoses. This information can help doctors to assess patients' health ailments more thoroughly.

"It's more accurate [because] the PrimeCare system considers every diagnosis for a complaint so that I'm not relying on my memory to remember all of the possible diagnoses of chest pain or right lower quadrant abdominal pain or [a] headache", Jamaludeen said.

Keeping Track of Inmates' Illnesses in a Timely Way

In addition to helping doctors get a handle on patients' health problems, the PrimeCare system improves doctors' efficiency in managing their patient-loads.

"It saves time because otherwise I would have to sit there and ask the patient question about his history and now, basically, I have the questionnaires that he has filled out in front of me," Jamaludeen said. "My job is to verify his answer, not ask him each question."

After receiving the PrimeCare report, Jamaludeen double checks the inmates' answers with them to make sure that the results are accurate. Armed with the offenders' medical histories and a list of possible diagnoses, he then examines them and decides upon a treatment course. That information, too, is entered into the PrimeCare system via the Internet.

"It prints the entire record for [each patient's] visit so at the end of the visit, I have a nice, typewritten report that is easy to read," Jamaludeen said. These print-outs help to keep better patient records because, without PrimeCare, Jamaludeen would have to take notes on the visits by hand and, he said, "most doctors handwritten notes are pretty much incomplete."

But PrimeCare's electronic record-keeping system has another benefit in addition to maintaining clear, legible inmate medical records; it documents all of Jamauldeen's interactions with offenders, which can be useful if there is ever a legal challenge to the medical care an inmate received at one of his city jails.

"Correctional facilities are mandated by law [to] provide medical care to inmates and if they don't, the inmates, being the litigious bunch that they are, they wind up getting big lawsuits, especially if there's any indication that they may not have gotten proper medical attention," Nelson said.

Saving Jail Systems Money

While PrimeCare can help document the medical care that inmates receive, it can also save physicians and jail systems money.

"A lot of the expense that is encountered in the jail setting is from patients going to the emergency room for evaluations. A lot of the cities and counties that run these jails have had a problem because the healthcare costs were rising [when, for] every little problem, the physicians would say 'send them to the ER,'" Jamaludeen said. "When you send the patients to the ER, there's an increased cost for evaluation."

With the PrimeCare system, the jails' physicians can make decisions, even if they are not at the facility, by viewing the inmates' records online, which saves the offenders and the jail staff a costly trip to the hospital. The cost of for a jail physician to use the PrimeCare system varies, depending upon their inmate populations and their usage, according to Nelson.

While the Hampton City and Virginia Beach City Jails are the only two currently using the PrimeCare Patient Management System, Nelson expects that his company's drive to increase brand and product awareness in the corrections industry will lead to many more jail medical providers adopting the system.

And, according to Jamaludeen, when that happens, physicians working in corrections will find that PrimeCare is an excellent tool for keeping track of inmates' medical conditions.

Resources:
For more information about PrimeCare, call Jerry Jennings at (561) 881-7318.
To contact Dr. Jamaludeen, call (757) 427-8069.