Audit slams jail medical system
Questions procurement process

Feb. 21, 2008 -- The Sheriff Department's three-year-old medical records system for jail and House of Correction inmates, acquired under circumstances that raise conflict-of-interest questions, is so bad it should be replaced, according to a new audit.

"The outlook for the current EMR (electronic medical records) system is not good," according to the audit. The audit was requested by the County Board. County Supervisor Lynne DeBruin was the chief sponsor of the measure seeking the study.

Direct and indirect costs of implementing and operating the system total about $1.3 million, the audit said.

"We estimate the annual cost of simply maintaining the sytem is about $446,000," the audit said.

County staff has done significant programming work to make the system work, the audit said. Projected cost savings are about $1.1 million short of projections, it said.

Many of the system's features have not been implemented and it is missing integrity and safety checks, exposing the county to a high level of risk, according to the audit. The system's performance has been unacceptable at the House of Correction, the audit said, which also said that some of the system's goals, such as standardizing clinical documentation, have been achieved.

The Sheriff's Department, in its response to the audit, disputed many of the findings and contended that the system saved more than the audit said it did.

The vendor, Sequest Tecnologies Inc., was selected in a process tightly controlled by a single county administrator despite the firm's lack of directly relevant experience, according to the audit.

"The venture with Milwaukee County represented the vendor's first experience in corrections and their first experience in corrections in a primarily medical setting," according to a report by SysLogic Inc., consultants hired to help with the audit.

The administrator in charge of the selection process previously had purchased a system from the vendor, according to the audit.

"More importantly, when the program administrator left county employment in early 2005, he shortly thereafter went to work for the same vendor that was selected," the audit said.

The administrator has been identified as Michael E. Kalonick, who was medical and mental health program administrator for the Sheriff's Department.

The selection process also was flawed in other ways, the audit said:

• There is little documentation to support key decisions. Documents lacking include the final results of the scores given to submitted proposals.
• No input was requested of the county's information technology division when technical specifications were developed. Technology staff also was absent from the panel reviewing vendors' oral presentations. "This exposes the process to speculation that specifications may have been written so broadly that a potential shortcoming in a vendor's technical expertise would not necessarily disqualify it from consideration," the audit said.
• The Sheriff's Department said project cost would account for 40% of the total evaluation points. "Together with no documentation of the evaluation forms or anything that summarizes the results, this factor could have been over-inflated in announcing the results so that choosing the vendor with no correctional-based experience appeared justified," the audit said

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