California prison record system cost doubles to $386 million
FOLSOM, CALIF. | A massive project to modernize medical record-keeping for California prison inmates has more than doubled in cost from original estimates to nearly $400 million in just three years, the latest in a long string of computer projects that have befuddled state government.
The federal court-appointed receiver who controls California’s inmate health care system approved the project in 2013 to replace the state’s antiquated paperbased records with an electronic system that can track the medical and mental health care of nearly 130,000 inmates.
But a year of delays means it now won’t be installed at all 35 prisons until the end of 2017, and inmate advocates are so concerned that they may seek to push it back even longer at some troubled prisons.
The cost ballooned from the original $182 million projection to $386.5 million now in part because the first estimate left out basics like the cost of maintaining the system and replacing worn-out equipment, according to documents reviewed by The Associated Press.
The receiver, J. Clark Kelso, said his office also failed to anticipate needing $13 million worth of mobile devices — 16,800 laptops, dictation machines and other gear. Nor did it include the extra software required for things as fundamental as incorporating inmates’ requests to see doctors.
Authorities last year added dental records to the system, and the latest estimate includes three additional years of operation.
“The more charitable description is we learned as we went along,” Mr. Kelso said in an interview. “We started out with as cheap a system as we thought we could use, and then along the way there were some things that we decided, ‘You know, we absolutely need these, it turns out.’ ”
The biggest problem was a pharmaceutical records system so complex that it turned out to be “damn near unusable” when it was tested last winter at three prisons, Mr. Kelso said: “The thing wasn’t designed, implemented properly.”
He brought in a new pharmacy chief in February and “told him his No. 1 job is to fix this.”
The drug-tracking system is working now, bringing benefits like automatically warning doctors when certain combinations of prescriptions could prove harmful, Mr. Kelso said.
Officials have discovered other issues along the way, include a major hurdle: Employees struggle to learn the new record-keeping system. Mr. Kelso had to slow down implementing the computer system in other prisons and intensify the training.
Physicians don’t like that the new system forces them to do more timeconsuming data entry that they used to delegate to nurses, Mr. Kelso said, though he expects them to eventually adapt.
The system has been installed at eight additional prisons since August.
“Everything’s going swimmingly,” said Mr. Kelso’s spokeswoman, Joyce Hayhoe.
Yet doctors who tested the system still are seeing about one-third fewer patients a year later, potentially leading to backlogs and poor treatment, said Steven Fama, an attorney with the nonprofit Prison Law Office that sued to force health care improvements.
California Department of Corrections and Rehabilitation employee Shellee Haun retrieves inmates medical records at a facility in Sacramento.