In March of this year, the General Assembly enacted HB2499 requiring the Virginia Department of Corrections (VADOC) to develop policies to improve the exchange of medical and mental health information and records of persons committed to a state correctional facility, including policies to improve access to electronic health records and electronic exchange of information and records for the provision of telemedicine and telepsychiatry.

Three months later, in June of 2019, the General Assembly enacted budget language to ensure inter-operability between electronic health records (EHR) at the Department of Behavioral Health and Developmental Services (DBHDS) and the VADOC. This budget language halted a three-year long procurement and business-systems analysis for an EHR at the VADOC women’s facilities. VADOC cancelled the ongoing request for proposals (RFP) and began contract negotiations with Cerner on the women’s facilities that originally had appropriated funds. More recently, VADOC received a pricing estimate from Cerner for the women’s facilities and is currently waiting on pricing estimates for the men’s facilities. The Department understands the General Assembly’s intent of this legislation: to improve the exchange of medical and mental health information. Currently, VADOC does not have an EHR system in any facilities. EHR systems can be complex and require procedural changes within an agency. Thus, it would be prudent to wait until the implementation of an EHR system to develop the policies. Drafting procedures to govern a system not yet in existence would be contrary to improving the exchange of medical and mental health information. Accordingly, the Department will create procedures to govern the access and exchange of medical and mental health information within the EHR system concurrently with the development and implementation of an EHR.

The Department has developed several new practices designed to improve the exchange of medical and mental health information and records of people in our care. Although, these are not in VADOC operating procedure, these practices could still be considered our policy and reflect the intent of VADOC to respond to the legislative language, even without an EHR.

These practices include the ability to search for information in cloud hosted archived records, encrypted email software for our medical departments, a new Health Insurance Portability and Accountability Act (HIPAA) compliant release form for state agencies, the continued use of an electronic medication administration record (eMAR), which is a component of an EHR and the continued use of telehealth for medical, dental and mental health, including telehealth agreements with the University of Virginia (UVA) and Virginia Commonwealth University (VCU) for HIV, Hepatitis C, and other specialty clinics. Once VADOC has implemented the EHR system the agency will submit an updated report with policies to improve the exchange of medical and mental health information and records.