The Greater Risk: Failing to Modernize Jail Health Operations

By Richard Forbus, MBA-HCM, CCHP-A

If you lead a jail today, you already understand the pressure.

The population inside our facilities is more medically and behaviorally complex than it was even five years ago. We are managing serious mental illness, substance use disorders and withdrawal, and chronic disease — often untreated — all while facing staffing shortages, tightening budgets and increased public scrutiny.

And when tragedy strikes — particularly an in-custody death — the questions are immediate:

• Were policies followed?
• Were checks completed on time?
• Was care provided promptly and correctly?
• Can you prove it?

In this environment, technology is no longer optional. It is a strategic necessity.

Technology will not eliminate risk. It will not replace custody staff. It will not substitute for leadership. But when implemented thoughtfully, it can reduce liability exposure, improve operational efficiency and strengthen defensibility in ways traditional systems cannot.

Monitoring: Supporting Staff, Strengthening Documentation

Visual checks remain foundational to jail safety. But they are vulnerable — to fatigue, staffing strain and documentation gaps.

Modern monitoring tools — including location tracking, biometric wearables and automated alert systems — can supplement traditional supervision. They provide time-stamped documentation, real-time alerts when conditions decline and objective data demonstrating responsiveness.

The goal is not to replace staff observation. It is to reinforce it. In litigation, documentation matters. In emergencies, minutes matter. Technology can support both.

Telehealth: Operational Efficiency Beyond Health Care

Every custody leader understands the cost of transports. They require escorts, create overtime, disrupt staffing patterns and introduce risk beyond the secure perimeter.

Telehealth will not eliminate all off-site visits, but even modest reductions in transports can yield measurable savings and reduced exposure. Telehealth also improves access to specialty providers — particularly in rural communities — and supports continuity of care before release.

Nearly everyone in jail will return home. Improving access to care inside the facility can improve public safety outside it.

Electronic Health Records: Defensibility in a Digital Era

Paper systems create vulnerability. Missing documentation, illegible handwriting and delayed entries weaken an agency’s legal defense and complicate internal reviews.

Electronic health records provide audit trails, time-stamped entries and better integration between custody and medical operations. They allow leaders to identify patterns, analyze performance and address gaps proactively.

As Medicaid requirements evolve and regulatory scrutiny increases, digital documentation is quickly becoming essential — not optional.

Screening Technology: Raising the Bar on Contraband

Contraband — particularly narcotics — fuels violence, overdoses and instability inside facilities.

Body scanners and related screening technologies are not perfect, but they are 100% effective at detecting metallic weapons and serve as strong deterrents at intake and after court or hospital returns.

Technology does not eliminate contraband, but it raises the bar. And deterrence alone can significantly enhance safety.

Data and Artificial Intelligence: Leading Proactively

Most jails collect data, but few fully leverage it.

Too often, risks are identified only after a critical incident, during a mortality review or after-action analysis. By then, multiple warning signs have already converged.

Artificial intelligence and advanced analytics offer something different: the ability to integrate data from multiple systems, identify patterns and flag potential risks before they escalate.

This is not about replacing leadership judgment. It is about strengthening it.

Data-driven leadership improves staffing decisions, supports budget requests and demonstrates proactive oversight to county officials and the public.

The Strategic Question

Technology in corrections is not about being cutting edge. It is about reducing liability, protecting staff, strengthening defensibility and improving public safety.

Jails are often ground zero for community mental health and substance use crises. Nearly everyone in custody will return to the community. What happens inside our facilities directly affects safety outside them.

The greater risk today may not be adopting new tools. It may be failing to evaluate and modernize operations in a rapidly evolving environment.

Leadership, policy and culture will always determine outcomes. But in today’s correctional landscape, technology is a force multiplier — one that can help prevent tragedies, protect careers and strengthen public trust.

Richard Forbus is the Vice President of Program Development for the National Commission on Correctional Health Care.