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The Correctional Health Services division of NYC Health + Hospitals provides health care to persons detained within the New York City criminal justice system. With approximately 43,000 admissions a
year, the team works around the clock to provide comprehensive health care services.

In 2016, the Patient Relations group in Correctional Health Services began searching for a system to handle requests and concerns about health care services. Following a successful implementation,
Correctional Health Services expanded Case IQ to other areas to improve its overall case management, tracking and reporting.

The Challenge

Requests and concerns from family members, lawyers and other advocates for inmates were being tracked using an Access database that was more than 15 years old and limited to data collection.

“That was a huge problem for us,” says Ben Farber, Correctional Health Services’ Senior Associate Director for Planning and Analysis. “From a BI perspective, the only data we could produce was
the number of complaints, the category and the department.” Without the ability to collect all case information in one place, produce comprehensive records for specific complaints or tie requests together on a patient level, managers were unable to spot multiple complaints related to the same patient, issue or
location.

“Another major concern was that we had a tremendous amount of paper,” says Farber. “Because it was just a simple data collection tool, we couldn’t scan information in, we couldn’t store emails associated with a case as part of a case. So we had to print out everything,” he says. “We had everything on paper so that we could produce it if we had a records request as part of freedom of information law or we were subpoenaed by the courts. It was a mess.”

Farber’s team began looking for a case management system for patient complaints that had the scalability, functionality and data requirements they needed, as well as the customer service necessary
to handle their unique situation. “Because of our niche environment, we wanted special attention,” says Farber.

The Solution

After evaluating several vendors, they found Case IQ to be the best fit due to its customer focus, responsiveness, functionality, and business intelligence tools.

“Having integrated web forms were an immediate value-add for us and the email functionality was enormous. Having that [email] thread right in the case was really valuable,” says Farber. And the ability
to start connecting incidents and complaints by event and by person was a game-changer for the team.

Before implementing Case IQ, reviewing these took the team 15 minutes per case. Today, this task takes five minutes per case. In the first six months with Case IQ, the team reduced the time spent on reviewing cases by two-thirds.

Other Uses

Following this successful implementation, Correctional Health Services began to look at other ways to improve operations with Case IQ. “We identified tons of other uses for [Case IQ],” says
Farber. “We added additional workflows for areas where we felt we had risk or a vulnerability in terms of data collection and management.” Case IQ helped to streamline the following areas of
Correctional Health Services’ work:

Case Management

An Case IQ module now tracks forensic psychiatric evaluations, which determine a person’s fitness to stand trial. The module allows cases to be assigned to a clinician, and progress on the case can be monitored each step of the way.

Requesting medical records must go through an approval process, which used to have delays of up to 10 days. Through Case IQ, the case manager can initiate a request from within the case. An email alert goes to the Medical Records unit with all the required information. The Medical Records unit uploads a PDF directly to Case IQ and all stakeholders are alerted that the request is complete. “That is a huge value-add. Since we’ve implemented this, we’ve had zero delays,” says Farber.

Tracking

When the wrong medication or the wrong dosage is administered, there’s an obligation to report this, as well as the outcome and any remedial actions that were taken. “Reporting of this was historically very low because there’s a lot of fear in reporting that information to administration, especially when there’s no negative outcome,” says Farber. “If there’s no harm to the patient, there’s been no incentive to report it. But now with web forms we’ve been able to create a mechanism for anonymous reporting,” he says.
“And for something that’s a rare event, we haven’t had to train people who might only need to use a system once a year. They can go to a web form and put in information and someone on the case team
picks up the information off the queue and finishes the investigation. That was a real value-add for us. It also allows us to do real-time reporting when it comes to sending information to other agencies as well as to City Council.”

The final phase of implementation will see all other incidents managed in Case IQ. “We see 800,000 appointments per year. There are a lot of jail situations that can prevent us from completing 800,000
appointments,” says Farber. “The one thing we’ve never been able to figure out is what is the overall time impact of an event on a jail clinic, whether it’s a lockdown or some event in the clinic that ceases operations.” Tracking and analyzing these incidents will provide Farber’s team with valuable insight to improve operations and make the division more efficient.

Reporting

“We are mandated under a law called Prison Rape Elimination Act, (PREA) where we have to record reports of sexual abuse. So we built an entire module in Case IQ to manage this,” says Farber. The team created new workflows for PREA reporting to replace an inefficient process that used Excel spreadsheets.

Tracking this information had been a multi-step process involving Word documents, emails and Excel spreadsheets. Spreadsheets weren’t always updated, resulting in errors when counting and tracking
incidents. Case IQ eliminated hours of administrative time and the risk of errors in this process while streamlining the reporting process with templates and accurate, timely data.

Correctional Health Services created another workflow to capture workplace violence information, which is required by law to track and report. Again, Excel spreadsheets were replaced with efficient intake, tracking and reporting functions in Case IQ, with immediate access to information and templates for timely, compliant reporting.

Before implementing Case IQ, compliance was difficult and time-consuming. “A Freedom of Information Law request is a good example of that,” says Farber. “Especially with our Patient Relations department, very often they would have to search through emails to try and find communications with doctors in a specific clinic…. That could take hours.” Today it takes minutes.

The Result

Streamlined: Correctional Health Services has been able to make case management, tracking, and reporting more efficient, allowing them to better serve patients. “We’ve eliminated the need to crunch numbers for simple frequency statistics, which is kind of amazing,” Farber says.

Efficient: Case IQ saves Correctional Health Services time.

• PREA reporting was streamlined, cutting reporting time in half.
• Linking and reviewing patient relations cases was reduced by two thirds.
• Delays in fulfilling medical records requests were eliminated.
• Freedom of Information requests now take minutes instead of hours.

Secure: Implementing Case IQ has reduced the risk to patient privacy. “Data lives in one place, versus living on spreadsheets that can end up anywhere,” says Farber. “That eliminates a huge risk.”