Left Behind in Electronic Access: Control Over Personal Health Information While Incarcerated

Patients increasingly expect timely, secure access to health information, a right reinforced by the Health Insurance Portability and Accountability Act and expanded under the 21st Century Cures Act. Yet millions of individuals receiving care in jails and prisons remain excluded from these advances. Incarcerated populations bear a disproportionate burden of chronic disease, psychiatric illness, and substance use disorders. For many, incarceration presents consistent contact with healthcare, though access to personal medical records during and after detention remains limited. Although the Cures Act prohibits most forms of information blocking, carceral practices prevent patients from viewing records, restrict communication with providers, and maintain electronic health systems that do not integrate with community platforms. Existing digital tools in prisons—such as TRULINCS, JPay, and fee-based tablets—facilitate communication and commerce but rarely support healthcare engagement. Incarcerated patients are excluded from digital health rights afforded the broader population, exacerbating disparities and complicating reentry into communities. Policy reforms should enforce Cures Act provisions within carceral systems, mandate interoperable EHRs that follow patients across settings, and leverage emerging tablet technologies to provide secure patient portals. Aligning correctional health practices with community standards would promote autonomy, facilitate continuity of care, and support rehabilitative and public health goals.