A Tale of Two Jails: Leveraging Electronic Consultation to Address the Specialty Care Needs of the Vulnerable County Jail Population

Abstract

Summary The Inland Empire Health Plan (IEHP), located in San Bernardino County, California — one of the largest not-for-profit Medicare-Medicaid plans in the United States — implemented an eConsult (electronic consultation) program in 2018 to improve care coordination and facilitate timely access to specialty care for all IEHP members. The program was soon expanded to include incarcerated individuals in two southern California county jail systems: Riverside County Correctional Health Services and the San Bernardino County Sheriff’s Department. The health plan’s Multi-County eConsult Initiative enabled primary care physicians (PCPs) serving the jail systems to consult promptly with specialists at regional health centers regarding care issues for inmates and to determine whether in-person referrals to specialists were warranted. IEHP’s review of eConsult’s impact on the care of inmates at these jails showed that over a 12-month period, 20% of all cases typically referred for in-person specialist visits were deemed unnecessary and were instead treated onsite by PCPs after consultation with the specialists. With this approach, access to specialists was more timely, efficient, and cost effective.