Each time a person moves between providers because of a transfer, referral, or lapse in treatment, he or she risks losing the valuable information about his or her condition and treatment that the first provider accrued. As a result, each new provider must at least re-interview the person for basic information. Worse, the provider might harm the person by re-administering medication or other treatment that has already been found to be ineffective or harmful to him or her. To avoid such inefficiency or risk to a person's health, jail and prison health staff should create and maintain an accurate and thorough summary health record, which would detail each person's condition and treatment for any serious physical, mental, dental, and substance abuse problems. Correctional health care providers should make sure to explain to prisoners what their confidentiality rights under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) are, but should also encourage them to sign a limited waiver so that this summary health record can be shared with other providers in the community. (See Policy Statement 8, Development of Intake Procedure, for more on confidentiality laws.)

Many health care systems already use a standardized document that can move with a patient to present a current snapshot of his or her condition and care to new providers. The American Public Health Association (APHA) has developed a model for a prisoner's health care summary. According to APHA, such a document should include the following information upon a person's release from custody: pertinent history; physical and laboratory information; follow-up plans for therapy; scheduled consultations; and prescribed medications. ^[1]   A summary health record should also provide information such as diagnoses, allergies, and recent procedures. Whether adopting an established standard for the contents of a summary health record or creating a new summary health record format, corrections staff and community-based health care providers should collaborate to create a common form and develop a protocol for its use. The form would ideally be computerized so that, with proper authorization, community-based providers could upload and update summary health records created in a corrections facility, or vice versa.

Correctional health care providers typically begin to prepare a person's summary health record upon his first admission to the facility, and complete it toward the end of his stay. Even in a jail setting, where a person may stay for only a day or two, the information gleaned from the initial health screening could be used to start a summary health record. (See Policy Statement 10 for more on correctional health care for jail stays.) For a prisoner who stays in a facility for a longer period of time, providers could create a more comprehensive summary health record. What is most critical, however, is that the summary health record be completed just prior to the person's release from prison or jail.

By organizing and summarizing health information and the basis for the transfer (whether release to the community or some other reason), the summary health record enables health care professionals to lay the groundwork for effective and efficient medical care from future providers. While the summary health record is neither a comprehensive electronic medical record nor a clinical repository, the summary health record could draw from these sources of information - including, in this case, records created during an inmate's incarceration - to produce a distilled document that addresses an inmate's physical health, mental health, and substance abuse treatment. (See Policy Statement 10, Physical Health Care, for more on the importance of keeping medical records for people during their incarceration.)

Each person leaving prison or jail should receive a copy of his or her summary health record to bring to subsequent caregivers in the community. In addition, where possible and where the individual has signed a HIPAA-compliant release authorizing the disclosure, correctional health providers should also send a copy of the summary health record to any anticipated community provider(s) either electronically or by fax. However the community provider obtains the summary health record, the new provider should refer to the document during the initial consultation with the patient and then update it before discharging or transferring the individual again, if applicable.