$7 Billion to Fix Calif. Prison Health Care

California Gov. Arnold Schwarzenegger says $7 billion ought to fix -- mostly -- the health care system inside California's 33 state prisons, IT included. Now I'm watching to see if state lawmakers agree, and pass Schwarzenegger's proposal, which he pitched Friday in Sacramento.

There's a lot to be done to fix the prison health care system in California, as we chronicle this week in our multimedia package. Inside California prisons, substandard medical care kills one inmate every week. The prison health care system is so bad the court ruled it cruel and unusual punishment and seized control from the state. A federal overseer, or receiver, has been in charge since 2005 and progress has been slow.

IT is part of the court-ordered prescription to ensure doctors do no more harm. Schwarzenegger's $7 billion request covers technology but a lot more, including basic medical supplies, desks, chairs, phones and construction of new buildings -- and renovation of old, crumbling ones -- so that there's room to examine and treat the 173,000 inmates currently incarcerated in the state system.

Just look at and listen to the obstacles to IT at San Quentin, here. Dan Marshall, an IT manager who has worked at San Quentin for 14 years (the first seven in nursing), points out that good IT can mean the difference between a patient getting correct medications or not; between a doctor appropriately treating a patient or not; between living or not.

IT, he says, "is not just convenience but a medical issue."

Clark Kelso, who got the receiver job in January, worked on the $7 billion proposal with Schwarzenegger's office, according to the LA Times. Kelso used to be CIO of the state and knows full well that as much as technology is not the single answer to what's wrong with prison health care, the sore lack of technology helped create big problems.

"We have to actually build out a statewide network infrastructure that has not historically existed. My IT background is very key in trying to make this transformation happen," Kelso told me. "IT by itself isn’t going to solve anything in California's prison health care system. We have to reach out each institution and try to build from the ground up a new way of doing business."

Sounds like a typical corporate overhaul, doesn't it? Except for a grave twist.

As Marshall puts it: "The primary purpose of the receivership isn't to save a boatload of money or spend a boatload of money. It's to get acceptable patient care."

That would be care that doesn't amount to cruel and unusual punishment, violating the Eight Amendment.

Here's how Kelso, with his CIO's mind, encapsulates it: 'Every death of a patient-inmate is reviewed by a medical committee to determine if it was preventable or possibly preventable. People look at that number and that number needs to go down. You're never going to get down to zero. But I do know we need to see a reduction."

Me, I don't know of many other situations where one of the key IT success metrics is to have fewer people die this year than last year.