National Institute of Justice Helps Facilities Implement Telemedicine Program. (Technology Update)
Waldron, Ronald J., Corrections Today
Health care provisions in correctional facilities can be costly, difficult and present security risks. Telemedicine can alleviate some of these obstacles, but implementing a telemedicine program can be a daunting task and it may not be the right choice for all facilities. To help correctional administrators with these issues, the National Institute of Justice (NIJ) has funded a two-part project. The first part demonstrates the potential advantages of telemedicine. The second part guides facilities through the necessary steps of implementing a telemedicine system.
A Successful Demonstration Project
In 1994, the departments of Justice and Defense established the Joint Program Steering Group (JPSG) to manage the development and testing of useful technologies. Telemedicine was deemed useful, therefore JPSG, in cooperation with the Federal Bureau of Prisons, conducted a three-year telemedicine demonstration project. Several federal prisons with different missions and security levels were connected through a telemedicine network -- one of which was the Federal Medical Center (FMC) in Lexington, Ky. FMC Lexington and a local veteran's administration hospital served as the hubs in the network, providing physician specialists and other health care professionals. An independent evaluation found that telemedicine could be a cost-effective method for providing health care to inmates in correctional settings. The results of the evaluation are published in NIJ's 1999 research report, Telemedicine Can Reduce Correctional Health Care Costs: An Evaluation of Prison Telemedicine Network.
Turning Research Into Practice
It is important to show the viability of an idea or program such as telemedicine, and it is just as important to take the next step and put that research into practice. The success of the telemedicine demonstration project led NIJ to develop Implementing Telemedicine in Correctional Facilities. This report walks correctional administrators through the necessary steps to implement a telemedicine program, from deciding whether telemedicine is right for their facilities to giving examples of telemedicine procedures.
Telemedicine is any electronic means of providing health care services, for example, a consultation call between two doctors. In the context of NIJ-funded projects and this article, telemedicine is the use of interactive video between two or more health care providers. At one end of the teleconference arrangement is the consulting physician, and at the other, the patient and his or her health care provider. The patient's provider describes the complaint and provides the consultant with relevant video pictures. For example, a dermatologist would be shown the patient's skin disorder with a special camera and an orthopedist might be shown how the patient's leg moves. Interactive video helps the consulting physician make a diagnosis.
Is Telemedicine the Right Choice?
Although telemedicine has been shown to be a cost-effective alternative to delivering health care, it still may not work for every facility. For example, a prison located close to a major health care facility may be able to obtain all the support for health services it needs, making telemedicine less attractive or cost-effective. Figure 1 shows the various steps an agency should take in determining whether a change in health care provision is warranted.
First, a medical requirement analysis must be conducted to determine the services provided. The present and near-future extent of inmate health care should be determined as well as the inmates' satisfaction with health care services. This also will provide baseline data in evaluating any new systems.
If the analysis indicates that a change is warranted, multiple alternatives, including telemedicine, should be considered. This process should include identifying the resources required for each alternative and performing a cost-benefit analysis for each. …