This article summarizes the findings from a federally sponsored evaluation of the extent to which telemedicine can improve health care in correctional settings as well as lower its cost compared with current correctional health-care delivery methods.
Telemedicine can be loosely defined as the remote delivery of health care via telecommunications. The demonstration project featured in this article involved the design, procurement, installation, and evaluation of a telemedicine system. This demonstration linked three Federal prisons in Pennsylvania and one Federal prison medical center in Kentucky to the U.S. Department of Veterans Affairs Medical Center in Kentucky. The evaluation showed that telemedicine was adopted rapidly by prison health care administrators and that it improved prisoners' access to medical specialists who were not otherwise available to them. It also showed that the costs of adding this new technology can be offset by substantial savings. State and local prison officials who are considering telemedicine should first identify other structural savings, such as air transfers. Telemedicine may save taxpayer dollars in systems hoping to reduce medical costs by accessing less costly specialists in distant locations and by being able to access them more often than is possible with visiting local specialists. The greatest savings are likely to occur in correctional systems that use costly air charters for individual medical trips over long distances. Contrary to expectations, telemedicine did not greatly reduce the number or frequency of trips outside the prison to local health care providers. Such trips were most commonly taken for hands-on diagnostic tests or surgical procedures, or for emergencies that would not be amenable to telemedicine. In jurisdictions where outside trips are less tightly rationed, opportunities to produce savings by using telemedicine may exist. A list of 4 resources