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Implementing Telemedicine in Correctional Facilities

By Daniels, Deborah J.

Description
Government Reference Publication

Excerpt
Excerpt: An experiment in the late 1990s and an independent evaluation of the experiment determined that providing long-distance health care to inmates is feasible through a system called telemedicine. Telemedicine uses telecommunications equipment that allows health care providers to see and diagnose inmates in prisons located far from health care providers’ offices. The experiment showed that prisons could improve inmate health care by providing remote access to more medical specialists while reducing prisoner transport costs and related security management costs. The National Institute of Justice (NIJ) and Bureau of Prisons, U.S. Department of Justice; and the U.S. Department of Defense cooperated in the experiment. Several Federal prisons with different missions and security levels were connected via a telemedicine network. One of the Federal prisons was a medical center. A Veterans’ Administration hospital in Lexington, Kentucky, was also part of the network. An independent evaluation of the experiment showed that telemedicine could play an important role in delivering quality health care in correctional systems. The costs and benefits vary according to the type and nature of institution requirements, but the costs of telemedicine equipment are continuing to decline. NIJ published a report of the evaluation in 1999 (McDonald, Douglas C., et al., Telemedicine Can Reduce Correctional Health Care Costs: An Evaluation of a Prison Telemedicine Network, Washington, DC: U.S. Department of Justice, National Institute of Justice, March 1999, NCJ 175040). The success of the telemedicine demonstration project led to the decision to use the information from that study to develop a manual on implementing correctional telemedicine. The information in this manual can be used by correctional administrators who are evaluating whether telemedicine is an acceptable approach to providing medical care in their facility. Planning The first section guides the reader through the decision process. A medical requirements analysis must be conducted to determine the services currently provided. The satisfaction of the inmates with the current health care services should be evaluated. Alternatives must be evaluated. If telemedicine is selected, an action plan must be developed. Implementing the Plan Implementing the plan requires stating the medical requirements in terms of telemedicine. One must know how the telemedicine system will be used in the facility. The performance requirements of the telemedicine system should be determined after careful analysis of state-of-the-art technology. Communications requirements must be determined, then evaluated based on the needs of the facility. Plans for facility requirements and necessary modifications must be made and implemented. Personnel must be recruited and trained for the telemedicine operation. Evaluating Needs The technology of telemedicine is unique and must be carefully evaluated and implemented. The hardware, software, and system features that are most cost effective must be identified and implemented. A variety of communication options are available, and these also must be evaluated for cost and capability based on the services to be provided. Space must be identified and, if necessary, modified to meet the needs of telemedicine. Through a careful and thorough planning and contracting process, a successful suite of telemedicine equipment and space can be acquired and installed.

Table of Contents
CONTENTS Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Implementing the Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Evaluating Needs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Determining Cost-Benefit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Purpose. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Demonstration Project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Implementation Decision and Planning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Implementation Decision Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Implementation Planning Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Technology Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Cost Estimation Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Appendixes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 A. Areas of Inquiry for the Medical Requirements Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 B. Telemedicine Review and Implementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 C. Telemedicine Cost-Benefit Model. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 D. Medical Requirements Analysis Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 E. Medical Requirements Analysis—Clinic Survey Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 F. Position Description—Telemedicine Coordinator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 G. Developing Telemedicine Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 H. Glossary of Telemedicine Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65


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Title: Implementing Telemedicine in Correctional Facilities  
Author: Daniels, Deborah J.
Volume:
Language: English
Subject: Government publications, Legislation., Economic & political studies
Collection: Government Printing Office
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Historic
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Publisher: Government Printing Office
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