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Telemedicine Can Reduce Correctional Health Care Costs: An Evaluation of a Prison Telemedicine Network

NCJ Number
Douglas C. C. McDonald Ph.D.; Andrea Hassol; Kenneth Carlson; Jeffrey McCullough; Elizabeth Fournier; Jennifer Yap
Date Published
March 1999
81 pages
A demonstration project that involved a leased telemedicine network linking four Federal prisons with a Department of Veterans Affairs Medical Center was evaluated with respect to the feasibility of remote telemedical consultations in prisons and the estimated costs and savings of such a system.
The network linked three Pennsylvania prisons and a prison health care facility in Kentucky with the medical center. The Kentucky facilities served as the hubs in the network, providing specialist physicians and other health care practitioners with prisons in the three Pennsylvania prisons from September 1996 through December 1997. The demonstration project added remote encounters with specialists via telemedicine to the routine primary care provided by prison employees; the specialty care provided through in-prison clinics; the use of local hospitals and other facilities in certain cases; and the transport of inmates needing extensive care to a Bureau of Prisons (BOP) Federal Medical Center, by air charter, if necessary. Data were collected from BOP management information and accounting systems, telemedicine site coordinators, and interviews with health services administrators and clinicians. Results revealed that telemedicine consultations were effective substitutes for direct consultations in specialties such as psychiatry and dermatology but not in cardiology and orthopedics. In addition, the use of telemedicine averaged 13-14 transfers by air charter to a Federal Medical Center, usually for psychiatric reasons. Moreover, prison officials and inmates expressed positive attitudes toward telemedicine. Findings indicated that savings are most likely to result when frequent, individual transfers via air charter are avoided and when telemedicine consultation replaces in-prison consultation. However, cost savings from trips averted to nearby medical facilities are more modest. Figures, tables, footnotes, and appended background information and additional results