Telemedicine Reduces Prison Health Care Costs

Corrections Forum, Fall 1999 | Go to article overview

Telemedicine Reduces Prison Health Care Costs


The utilization of telemedicine could save prisons significant amounts in health care costs, according to a recent report titled, Telemedicine Can Reduce Correctional Health Care Costs: An Evaluation of a Prison Telemedicine Network. According to researchers, telemedicine - the remote delivery of health care via telecommunications - is the practical solution to the substantial problems associated with travel to deliver or receive medical care. This technological innovation is seen as a possible solution to rising health care costs, which can amount to 20 percent or more of total prison operating costs, according to the report.

Sponsored by the U.S. Department of Defense and conducted by the U.S. Department of Justice, National Institute of Justice (NIJ), the study focused on a network of four federal prisons, which included two maximum security prisons with an average of 1,349 and 1,037 male prisoners, respectively, a low/medium security prison with a daily average of 1, 100 male prisoners, and a prison health care facility with a daily average of 1,450 male and female prisoners. The principal objective of the study was to test the feasibility of using an advanced network of telemedicine equipment for remote specialty consultations and develop data to determine the impact of telemedicine on health care spending for a prison population. In addition, the report listed three secondary objectives - to reduce security risks associated with taking prisoners to community-based providers outside the prison walls for treatment or diagnoses, provide access to specialists of a kind and quality not available locally, and reduce delays in prisoner access to medical specialists.

According to the report, the current telecommunications, satellite infrastructure, the Internet and telephone wires, coupled with the advances in the ability to capture, store, transmit and display electronic representations of medical information, allow doctors to practice by remote access rather than personal consultation. Health care costs for prisoners are increasing, according to the report, and prison population demographics show a trend toward older offenders who serve longer sentences and have greater health care needs. Secondly, prisons are often located in remote geographic areas where access to health care specialists is difficult to arrange. Providing specialized medical attention may entail an expensive trip outside the secure perimeter for the prisoner, or a time consuming and expensive visit to the prison by specialists. Finally, there are diffIcult medical cases that could take months to resolve under normal circumstances that can be treated with more efficiency through telemedicine because the pool of specialists is larger and more accessible, according to the report.

Medical care in most federal prisons is traditionally delivered through four types of providers:

* routine primary care offered by prison employees;

* specialty care provided by in-person clinics contracted on an annual basis with local specialists;

* hospital care that requires transportation to nearby hospitals; and

* extensive care that requires transportation by air charter to a Justice Department, Bureau of Prisons (BOP) Federal Medical Center

To determine whether the prisons could use telemedicine to overcome problems in accessing medical specialists and improve security by avoiding travel outside the prison, the evaluation network supplied a fifth mode of care - remote encounters with specialists via telemedicine. Researchers found that telemedicine was quickly adopted and frequently used in medical specialty areas. Physicians reported that telemedical consultations were effective substitutes for direct, in-person consultations in some specialties, such as psychiatry and dermatology, but less than adequate in others like cardiology and orthopedics. The use of telemedicine avoided 14 transfers by air charter to a federal medical center, and saved approximately $59,000. …

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