Telemedicine could make prisons healthier, safer, and less expensive
In early 2017, a prison riot at the James T. Vaughn Correctional Center in Delaware turned into an ugly hostage situation that left one correctional officer dead. In the wake of this event, a close eye was turned to the safety of those who work at correctional institutions in the state.
More specifically, in order to keep health services employees safe — doctors, nurses, psychiatrists, etc. — the Delaware Department of Corrections (DOC) began to introduce telemedicine in its prison system.
In states across the country and outside of the corrections realm, “telemedicine”––the use of two-way video and audio between patients and doctors who are located remotely from the patients –– has already shown great promise in bridging the financial and geographical gaps between patient and provider. While safety was the impetus for turning to telehealth in the wake of the 2017 riot, less than a year later, this technology has saved money, increased access to specialists and quelled physician safety concerns.
According to a study by Pew Charitable Trusts, Delaware currently spends about $8,408 on healthcare per inmate, which is $2,688 more than the national average. According to a 2013 study from the Urban Institute, the percentage of corrections costs that go to inmate healthcare ranges from nine to 30 percent.
Collectively, inmate healthcare costs amount to hundreds of millions of dollars. However, since its introduction, telemedicine has allowed Delaware’s DOC to save money by reducing the need for additional corrections officers required when doctors are on site.
While an estimate is not available, the cost savings could be significant given that overtime is projected to surpass $30 million this year. Indeed, the use of telemedicine in Delaware has proven to be a viable option that would help to reduce the high cost-per-patient figures in not just Delaware, but other states as well.
In addition to the cost savings, telemedicine also ensures that inmates can access the care that they need. According to Dr. Christopher Moen, chief medical officer for Connections Community Support Programs (the contracted health care provider for the DOC), nearly 100 inmates across the state have used video telemedicine to date.
Additionally, Dr. Marc Richman, chief of the Bureau of Correctional Healthcare Services for the Delaware Department of Correction, recently outlined the scope and use of telemedicine in the State’s other correctional facilities. Baylor Women’s Correctional Institution, Howard R. Young Correctional Institution and Sussex Correctional Institution all used telemedicine for medically assisted withdrawals; while at Vaughn, telemedicine is primarily used by inmates on dialysis.
In fact, Delaware’s use of telemedicine is part of a growing trend in the United States. A 2016 Centers for Disease Control (CDC) survey found that 30 out of 45 states that responded to a federal survey used telemedicine for at least one type of specialty or diagnostic service in 2011. The services that inmates sought ranged from psychiatry and cardiology treatment to infectious disease screenings.
In addition to the cost savings and increased access to physicians, a report from the U.S. Department of Justice’s Office of Justice Programs found that use of telemedicine video technology in prisons improved staff and physician safety as well. According to Dr. Richman, prior to the implementation of telehealth in the state, if an inmate needed to see a specialist, they had to travel, which required two to three correctional officers to leave the prison with the inmate – a significant safety risk and cost to the community as a whole.
In the aftermath of the 2017 riots at the Vaughn Correctional Center, some doctors were hesitant about visiting inmates in prison. However, with telemedicine, inmates are able to talk with a doctor via a Skype-like app on an iPad or laptop in the prison’s medical office. The only medical staff that needs to be present is a nurse practitioner who typically stays with the inmate to answer doctors’ questions and to take vitals.
With benefits such as increased savings, increased safety and expanded access to physicians, the use of telemedicine has many practical applications inside and outside of prison walls.
