Health Aff (Millwood). 2014 Mar;33(3):487-92. doi: 10.1377/hlthaff.2013.1125.
The 1976 Supreme Court decision in Estelle v. Gamble declared that jails must provide medical treatment to detainees consistent with community standards of care. Yet despite their important role providing health care to about ten million people a year, jails remain largely siloed from the surrounding health care community, compromising inmates' health and adding to health care spending. Health information technology promises solutions. The current policy landscape, shaped by the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Affordable Care Act, is favorable to jails' implementation of health information technology (IT). In this article we examine how decisions largely external to jails-coming from the Supreme Court, Congress, and local policy makers-have contributed to the growth of health IT within jails and health information exchange between jails and local communities. We also discuss privacy concerns under the Health Insurance Portability and Affordability Act and other legislation. This article highlights a rare confluence of events that could improve the health of an overlooked population.
1976 年最高法院在 Estelle v. Gamble 的判决中宣布，监狱必须按照社区护理标准为被拘留者提供医疗。然而，尽管监狱每年为大约 1000 万人提供医疗保健，但它们在很大程度上仍然与周围的医疗保健社区隔离，损害了囚犯的健康，并增加了医疗保健支出。医疗信息技术提供了解决方案。当前的政策格局由《经济和临床健康信息技术法案》（HITECH 法案）和《平价医疗法案》塑造，有利于监狱实施医疗信息技术（IT）。在本文中，我们研究了监狱外部的决策——来自最高法院、国会和地方政策制定者——如何促进监狱内部医疗信息技术的发展以及监狱与当地社区之间的医疗信息交流。我们还讨论了《健康保险便携性和可负担性法案》及其他立法下的隐私问题。本文强调了一个罕见的事件融合，这可能会改善一个被忽视的人群的健康状况。
