Centurion Health Chief Clinical Officer Johnny Wu is used to technology workarounds in healthcare since his company is focused on serving patients in prisons.

I caught up with Wu at Constellation Research Connected Enterprise to talk shop. Here are some of the takeaways from Wu, a BT150 member of the 2024-2025 class.

The role. Centurion Health provides healthcare inside of prisons and part of Wu's role is delivering care when it has to work around technology restrictions. "We provide care inside of prisons and it's challenging due to the limitations of prisons--concrete, rebar, lack of being able to bring in cell phones--but we are trying to provide care by going directly to patients," said Wu. "We have a captive audience, but sometimes we don't have access to them."

Technology workarounds. Wu said the company is starting to use tablets and use telehealth inside prisons. "I provide direct patient care and oversee that, but the IT department is constantly building datasets so we can provide better care in real time," he said.

There are no electronic health records that are standardized across states. Wu said:

"There's a lot of jurisdictions that we have to deal with. Each state has its own prison health system. There's also the federal system, and then the county jails, and they don't communicate. They have different budgets. You could be working in a system where they have very robust resources and electric health records. Some are actually still working on paper."

Multiple requirements and regulations. Wu said each contract in the prison system has different contract requirements and regulations. Centurion Health is a centralized group that attempts to standardize across the US, but often there's a consultation with the local level on how to make things work.

What Wu would fix? Wu said:

"We need to just move away from the mindset that we have to do things the way we've always been doing it, and then adding technology. We just need to start fresh. I would like to be able to have mobile technology, be able to have Wi-Fi or cellular service inside the prisons. I have folks who I can't even communicate with because there's no way for them to have a cell phone inside the prison while they're working."

Telehealth. In prisons, telehealth is typically a standalone machine sitting in front of a patient with a chaperone. On the other hand, the provider could be remote in another location. Wu said:

"However, the software that goes through the internet is very limited, very impersonal. We're moving towards to be able to have using peripherals where we've actually gotten permission to collect data. We can collect heart rates, sounds of their hearts, their lungs, and in real time the provider at the other end can hear this and adjust treatment plans."

Wearables. Wu said Centurion Health has been looking to use wearables, but "security trumps everything." He said:

"Wearables are made to be too small and for consumers. For our world, a wearable could be swallowed or hidden. It poses a challenge to have permission to use wearables. We have to rig and make our own type of wearables, which is not always ideal, but we do what we can. We're looking at using sonar to be able to collect some information, but we're working in the house of custody where we don't own the physical plant or office space. We can't make changes that easily."

How things have changed. "The client understands that there's an obligation to provide health care and you have to make sure each side is supporting each other. When I started my career in correctional medicine I was working in a broom closet or sometimes a jail cell. Today new prisons have medical people involved with the design," he said.

Rewarding part of job. "Patient care is rewarding," said Wu. "A lot of times it's as simple as going into a facility and talking to people. They remember me and it's just rewarding to know that people appreciate what we do," he said.

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