Report 2009-107.1 Recommendation 13 Responses

Report 2009-107.1: California Department of Corrections and Rehabilitation: It Fails to Track and Use Data That Would Allow It to More Effectively Monitor and Manage Its Operations (Release Date: September 2009)

Recommendation #13 To: Correctional Health Care Services, California

To increase the use of the telemedicine system, Health Care Services should continue to implement the recommendations that it has adopted from the consultant's review of telemedicine capabilities.

Annual Follow-Up Agency Response From October 2014

CCHCS has completed all of the short-term goal recommendations and long-term recommendations from the consultants review (Attachment 1).

The CCHCS has completed implementation of a basic electronic medical records management system. The CCHCS Telemedicine Services (TMS) currently utilizes three enterprise applications, Telemedicine Scheduling System (TMSS), Electronic Unit Health Record (eUHR), and Report Manager, to effectively manage telemedicine scheduling and health information storage and retrieval.

Nursing Service's Professional Education Unit developed a standardized statewide curriculum inclusive of telemedicine clinic overview/management; mock clinic skills return demonstration, and knowledge competency validation. Initial training was provided to the Nurse Consultant Program Review staff on August 11, 2014. The training session sign-in sheet is enclosed (Attachment 2). Ongoing training will be provided to the statewide telemedicine nursing staff on this curriculum on

October 17, 2014.

The enterprise eUHR and the Medical Scheduling and Tracking System (MedSATS) scheduling system are fully deployed and operational. A more robust CCHCS/CDCR enterprise eUHR (including scheduling) development is tentatively planned for implementation commencing in 2015.

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

Annual Follow-Up Agency Response From November 2013

Details on the implementation plan and status are summarized in the attached table (Attachments 10-13)

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From September 2012

CCHCS has implemented thirteen of the sixteen short-term goal recommendations and six of eight long-term goal recommendations from the consultant's review. Implementation of the consultant's recommendation to initiate basic electronic medical record document management for telemedicine and develop clinical outcome analysis and cost savings benchmarks for measuring the telemedicine program awaits full implementation of the CCHCS electronic medical record procurement project currently under way. Implementation of the consultant's recommendation to develop and communicate vision/plan widely to include using telemedicine as required principal escalation for both primary care and specialty consults is a continuing effort following the June 1, 2010 Implementation of Telemedicine as Default Policy. (The policy memorandum was provided to the Bureau of State Audit for the SB 1452 requirement in previous year.) Implementation of the consultant's recommendation to institute comprehensive and timely training and appraisal review process has been slow due to limited resources for training, significant turnover in institution telemedicine staffing in early 2011, and nursing staff responsible for training/appraisal being under a separate management structure from the telemedicine program. Implementation of the consultant's recommendation to develop treatment protocols for all disease management groupings will not be implemented for specialty care contractors as CCHCS relies on those board-certified specialists expertise which exceeds the specialty expertise within CCHCS.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

All Recommendations in 2009-107.1

Agency responses received after June 2013 are posted verbatim.