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Ensuring Effective Data Exchange Practices May Improve Reentry Outcomes

Data Sharing between Jail and Community Health Systems: Missing Links and Lessons for Re-Entry Success
Geoffrey Glowalla, Vignesh Subbian
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Many people incarcerated in jail or prisons are experiencing or at risk of homelessness. Because of the vast amount of data about this population in jail health systems and local community health systems, understanding the size and scope of their needs is challenging. This lack of understanding, paired with barriers to communication between justice, health, and community organizations, poses significant challenges for reentry for people after they’re released. Linking the health information of people released from jail or prison to community providers is critical for successful community reintegration.

To help increase interoperability between jail system and the community, this case study analyzed the Orange County, California, Jail Information Exchange System and its interoperability capacity with community providers. Specifically, it investigated the county’s jail to community reentry program, which aimed to achieve five goals: to improve mental health–related outcomes, increase access to community services and government assistance programs, increase connection with family and other support systems in the community, utilize evidence-based interventions to address substance use issues and lower risk for recidivism, and improve interoperability between organizations for a coordinated and effective reentry system.

Using a case study approach, the authors used two outcomes to measure program success: the quantity of referrals made to the community and the number of successful linkages of people released from jail to community providers.

Key findings
  • The number of referrals made from jails to the community since the start of the reentry program increased significantly. But, despite the significant increase in referrals from jail to community providers, the linkage rate was low (10 to 15 percent).
  • The reentry program identified three reasons for the low rates of successful linkages: a lack of jail/prison in-reach services, meaning contact made by community service providers when the person is still within the jail or prison; the inability to provide a warm handoff of people released from jail to community service providers; and the inability to exchange health data between jail and community providers.
  • Jail in-reach programs provide an opportunity for people who will soon be released from jail or prison to make contact and build rapport with community service providers before their release.
  • Programs that provide a warm handoff through direct transportation between jail and community service providers had significantly more successful linkages.
  • The inability to exchange health data between jail and community providers led to patients being referred to inappropriate levels of care, poor coordination between jail and community, and lapses in treatment from community to jail and vice versa.
Policy implications
  • Communication and coordination between the community and jail system is crucial to ensure successful linkages. Without robust and effective health information exchange systems and practices, even linkages in a community with substantial resources and services would be negatively affected.
  • For a county to implement effective data exchange systems between jails and communities, there must be champions pushing for policies that encourage interoperability to ensure effective jail integration with the community. The data being exchanged need to be relevant to provide continuity of care between jails and the community service provider while enabling the service providers to assist with accurate and effective care coordination.