Colorado Using Telemedicine to Reduce Inmate Healthcare Costs
Date:  06-19-2013

Some “bumps in the road” foreseen as new program is implemented
Inmate health care takes a huge chunk out of corrections budgets. On March 14, 2013 Reentry Central posted “Inmate Healthcare: Providing Care While Reducing Costs.” The article contained a link to the Urban Institute report “Opportunities for Cost Savings in Corrections without Sacrificing Service Quality: Inmate Health Care.” The report offered several suggestions for reducing costs while providing adequate health care to inmates. One of the suggestions was implementing telemedicine in correctional facilities. Telemedicine allows doctors in a nearby medical facility to communicate, and visually examine an inmate via computer monitors. As Reentry Central stated in the article:

“Real-time interactive telemedicine might be the wave of the future in prisoner health care, but it does not come without the initial cost of special equipment, and is more cold and impersonal than a visit with a doctor or nurse who is physically in the same room with a prisoner. The Federal Bureau of Prisons has used telemedicine for inmates under the care of a psychologist or psychiatrist. Talking to a medical professional over the phone, or on a TV monitor, can be unnerving, or embarrassing for some.” Telemedicine also has some drawbacks. A physician using the telemedicine system could not palpitate a mass, for example. And, electronic communication works only when a system is up-and-running; extreme weather and sunspots can cause a breakdown in communication. Still, there are advantages to using telemedicine, and for corrections department it is all about saving money.

Government Technology reports that the Colorado Department of Corrections has teamed up with Denver Health Medical Center to use telemedicine. The following article is reposted with permission.

Colorado Experiments with Telemedicine for Inmates

May 17, 2013 By Brian Heaton

Specialized medical care will soon be a point and click away for some Colorado inmates.

The Colorado Department of Corrections and Denver Health Medical Center are launching a telemedicine pilot program in June for incarcerated patients that need consultations in the areas of rheumatology, infectious disease, orthopedics and general surgery. Instead of office visits, inmates and doctors will meet using high-definition video conferencing.

The state hopes the program will reduce the risk of prisoner escape and save money by avoiding costly offsite trips to the medical center. Nineteen different corrections facilities in Colorado will take part in the telemedicine effort.

“A lot of these transports occur after hours, so you have to pay the security detail overtime,” said Chris Wells, director of healthcare information technology architecture in the Colorado Governor’s Office of Information Technology. “The program improves accessibility to specialty care and there’s been some use cases throughout the U.S. about inmates escaping, so this decreases the risk.”

In addition, because both Denver Health and the Colorado Department of Corrections have modern video conferencing systems, there are no up-front costs associated with the program for either party.

This isn’t the first time the department has dabbled in telemedicine. According to Liz Mestas, clinical support services manager for the Colorado Department of Corrections, it was tried about 20 years ago for dermatology patients but didn’t work out.

Department staff set up TVs and machines so they could zoom in on skin issues such as a rash, enabling the doctor to do a diagnosis. Mestas said the problem wasn’t the technology — it was scheduling. If doctors were running late, it meant an inmate and the transport team would be waiting for hours, leading to overtime costs for the officers.

Mestas added that has changed now, as Denver Health schedules blocks of time on certain days for various specialty areas, making the process easier.

“[The doctors] are going to be there anyway, so now we’re just going to get them on the television,” Mestas said. “We’re going to use the same blocked time for that instead of driving offenders to the appointment.”

Preparatory Work

The Colorado Department of Corrections is busy this month installing connections in various areas where the telemedicine appointments will take place. Video conferencing has been used in some facilities already so that inmates can meet with psychiatrists on mental health issues.

From the department’s perspective, the major challenge with regular telemedicine use is deciding what inmates it should be used for. Mestas said her team is made up of mostly clerical employees, while most of the people involved with the program on Denver Health’s side are non-clinical. The last time the groups met, it was decided Denver Health would make the appointment determination.

“They are going to have to get the medical records first, have their doctors review it and see if the inmate can be seen by telemedicine or if we have to bring them on site,” Mestas said. “That’s going to be the biggest obstacle.”

Wells concurred and added that he expects a few bumps in the road until corrections and hospital staff members are comfortable with the telemedicine program and various operational protocols. Training materials are being prepared this month to help those involved get up to speed quickly.

If the program is successful, Wells hopes to expand it to include other specialties and hospitals in the future. Right now, the video conference will just be a simple remote link between the inmate and doctor. But over time, Wells would like to use the system to transmit images and other medical data as appropriate.

“I want to be able to show that the technology these days is not the issue,” Wells said. “You can do this over the Internet. E-commerce, online retailers, that sort of thing have been able to transmit sensitive data for years. So expanding this out to healthcare is the next level.”

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