It’s not entirely surprising that providing healthcare to inmates is a complicated, politicized challenge. Cost, coverage, ultimate responsibility for payment, and countless other factors all pose questions for which there’s no easy answer. For this reason alone, good news regarding inmate health care — that is, news in which a program or policy results in better care for inmates and simpler processes for the entities housing them — is always a breath of fresh air.
Such is the case in a recent piece covering the emergence of telemedicine services in Midwest-area jails and prisons. The services, which allow inmates to receive care from remote physicians via a computer monitor and webcam, have seen noteworthy success across the corrections system. Stakeholders praise the financial efficiency while inmates appreciate the chance to receive care without uncomfortable, lengthy off-campus visits.
More, many of the advantages enjoyed by corrections agencies and inmates effectively apply to any health system or individual provider. In this sense, the success of telepsychiatry services in corrections is a strong showcase for the emergent care model: If it can be “plugged into” one of the most challenging care environments around, it can be of great benefit anywhere.
For Health Systems, Benefits of Telemedicine are Universal
Recent coverage out of Texas, a leader in public-sector telemedicine and telepsychiatry adoption, confirms this idea. As the second largest U.S. state and the first in terms of overall prisoner load, providing basic care — let alone access to specialized services — can quickly become a logistical nightmare, with prisoners being transported hundreds of miles at times. Access to telehealth services, meanwhile, means the same prisoner can be seen from a dedicated room within the facility.
While the corrections environment and legal imperative to provide inmates with care complicates matters, the high-level situation matches challenges faced by any health system serving remote communities. When a patient is too elderly or ill to travel long distances or can’t afford home-based care, travel to a local clinic with telehealth capability offers a viable alternative. By the same token, the system improves its reach into rural areas without the rigors and costs of staffing full-service clinics.
Standardization of care presents another universal benefit. In Texas, the same health agency conducts more than 150,000 telehealth visits per year across 83 facilities — visits that may have been undertaken by an ad-hoc collection of healthcare contractors if telehealth wasn’t available. It’s much the same story in a non-prison healthcare environment, where keeping a patient under the same organization’s wing means a fuller view of their overall health history, and thus better care. As above, telemedicine and telepsychiatry services allow public-serving organizations to extend their reach to homebound, rural, and other hard-to-see patients, providing continuity and quality-of-care benefits that may otherwise be impossible to obtain.
Exploring Telehealth’s Provider-Focused Advantages
Health systems aren’t the only ones that benefit from expanded telehealth services, however. Turning specifically to corrections work, individual providers who would otherwise never consider working in a jail or prison can use the care model to serve a medically diverse population with far less risk than an in-person visit poses.
Proof of this can be seen in the above-linked article on Texas prisons, which opens with a rather distressing story. A prisoner, insistent on receiving a prescription for “a particular medication,” threatened to kill a psychiatrist who would not bend to his demands. Today, the article says, the psychiatrist “feels a lot safer” thanks to telemedicine and telepsychiatry, because he dispenses advice and prescriptions from the comfort of a suburban office.
Now consider the physician or mental health professional who would be happy to augment her income with prison visits (and serve a needful population in the process), but fears for his or her safety during in-person visits. Contracting with a telehealth service for a set number of virtual visits allows her to meet all three needs: In essence, he or she realizes all the professional and financial benefits of corrections visits with none of the risk.
It should also be noted that others enjoy the unique challenges of serving corrections- and managed care-based patients in person. For these professionals — and those interested in exploring the option in a try-before-you-buy capacity — standard locum tenens work provides a chance to explore a variety of correctional settings without committing to a single location: As nurse practitioner Renee Dahring notes, providing care in a jail or prison offers professional satisfaction, exciting work, and a lack of insurance drudgery, all in a workplace truly unique from any other clinical setting.
Telehealth Works — In Corrections and Elsewhere
Telemedicine services are often presented as a smart solution to the prisoner care dilemma. Ultimately, however, the strengths that make virtual visits so attractive to corrections and governmental stakeholders apply just as well to organizations and systems serving the larger public. That it works so well in such a challenging environment is simply a sign of its overall strength as a care delivery model — a fact everyone in a telehealth care chain, from physicians and patients to financial stakeholders, can readily attest to.
