The Henrico County, Virginia, Sheriff’s Department operates two regional jails, one of which is considered a “new generation” facility with state-of-the-art systems, policies, and programs. Ironically, though, the jails were using an outdated, inefficient process of providing medicines to their inmates.

The two jails house a constantly changing population of approximately 1200 convicts, most of whom are serving shorter sentences (typically less than 12 months) or are awaiting transfer to another site. Having such a large and transient group makes it difficult to establish routines or to get familiar with individual inmates’ needs, so Henrico County implemented a comprehensive tracking system that enabled the Sheriff’s Department to monitor the movements and locations of inmates. Using RFID technology and smart scanners, it was then much easier to know who was where and when at all times. However, the package didn’t include a medical component, which presented new problems.

About half of the Henrico County jails’ inmates get some form of daily medication, many as often as four times a day, and trying to track it all manually was a tremendous challenge. The process was an ongoing series of hassles with a risk for mistakes at almost every step. The jail staff includes a doctor, dentist and psychiatrist who would prescribe inmates’ medications via hand-written requests. Staff nurses then distributed the medications directly to prisoners, either delivered from a push cart going cell-to-cell or handed out from a service window in the jail’s Day Room. In each case, when an inmate was given his medication, the nurse would simply make a written note of the exchange and enter it in a paper log book.

“That left things wide open for abuse and legal issues,” said Beverly Jordan, IT Project Leader for the Sheriff’s Department. “An inmate could claim he never got his medication, or that we gave him the wrong thing, or that he had already taken his meds when he really hadn’t. There was no accountability. We needed to be able to prove what we did.”

To complicate the process, prescription medications which the doctors ordered had to be delivered from pharmacies off-site. Those inbound medicines then had to be manually logged into the paper records as well. In the case of prescription refills, a staff nurse had to literally look at the remaining pills and count them to determine what was on hand and when to order more.

In October of 2006, Beverly was put in touch with SpiralFX, who then began developing a customized software solution to address the jails’ needs. SpiralFX created a unique application named “Docktor” to automate the medication distribution process and interface seamlessly with the jails’ existing tracking systems. Now when a staff physician orders a prescription, the request is immediately entered into a master database, complete with patient history and dosage and refill information. The system then automatically sends the prescription to the pharmacy to be filled.

Each prescription received by the jail now carries a bar code. The code is scanned and electronically records the delivery into the system, which also specifies distribution instructions per inmate. When the staff nurses are ready to hand out medications to prisoners, the Docktor software creates a printed list with a barcode for each prescribed dose. As an inmate approaches to get his medicine, the nurse scans his bar-coded wristband along with the bar code on his prescription. The system verifies the patient match and then enters the transaction, creating a digital record of every medicine taken by every inmate, complete with a date and time stamp. Additionally, the software alerts jail staff members to any patients who did not receive their medications that day.  

“The new system lets us do things we could never do before,” said Beverly. “Now we’re able to track who ordered what medication, and who gets it, and how much, and we can track when it was issued and distributed. It’s also really helped for auditing purposes – now we can reconcile our inventory.”

Other advantages of the software include automatic notification of prescription refills, reminders of scheduled doctors’ visits, instant creation of new patient files, and more. The system also develops DHTML and/or Crystal reports that provide information about the inmates and their various respective medications. In general, the new process has greatly enhanced the efficiency and accuracy of how medications are distributed at Henrico County, and minimized concerns about accountability and legal issues.

“Nothing like this had ever been done before, and it was definitely a successful implementation,” said Beverly. “SpiralFX is very conscientious, and they really responded to what we needed. I would recommend them.”

For more information about the Henrico County jail sites, please go to www.co.henrico.va.us/sheriff/, or to contact SpiralFX, please click here.