A Telemedicine Model for Emergency Care in a Short-Term Correctional Facility

Abstract

The primary objectives of this research were to determine the effectiveness of a personal computer-based telemedicine system for semi- and nonurgent complaints at a short-term correctional facility and to evaluate the system as a potential model for providing emergency care to remote locations. We performed a retrospective review of medical records of patients referred to the emergency department in person or via telemedicine during a 12-month period. The data included system utilization, chief complaints, physical examination, diagnostic testing, disposition, and outcomes in patients evaluated via telemedicine. Also identified were nursing diagnostic and procedure skills associated with successful evaluation via telemedicine. A total of 530 emergency care records were reviewed with 126 telemedicine consultations performed. Eighty-one of 126 (64%) telemedicine patients remained at the facility following consultation with the remaining 45 (36%) being transported to the emergency department. Rates of return to the emergency department within 7 days following consultation were comparable, patient acceptance and satisfaction was high, and there were no untoward outcomes in the group. Average total time of telemedicine consultation was 30 minutes versus a 2-hour and 45-minutes turnaround time for an emergency department evaluation. A variety of emergency complaints were managed effectively using relatively low-cost computer-based telemedicine technology, thereby eliminating the need for transportation of the patient to the emergency department. This system provides an emergency physician-nurse model for conduction limited emergency care in remote settings.

Integration of Telemedicine Practice Into Correctional Medicine: An Evolving Standard

“…Telemedicine has been applied to many specialties, including infectious diseases such as HIV and hepatitis C (Sterling et al, 2004), emergency medicine, and psychiatry. Importantly, it can provide access to a specialist in emergency situations where an immediate diagnosis can profoundly affect the patient's outcome (Burdick et al, 1996;Ellis, Mayrose, Jehle, Moscati, & Pierluisi, 2001).…”

“…Studies have "strongly supported telepsychiatry's efficiency, cost effectiveness, and high diagnostic reliability" (Ellis et al, 2001). Use of telepsychiatry at FMC-Lexington was thought to result in more effective medication and monitoring of mentally ill patients at the participating four institutions ("Prison Telemedicine," 1998).…”

Use of telemedicine in the European penitentiaries: current scenario and best practices

“…They included models whereby local and Sanitary System augment prison health care through telemedicine. [29][30][31] In the USA, for instance, use of telemedicine started in July 1997 with pulmonary, orthopaedics, diabetic, and dermatology offerings, and currently telemedicine is a key part of an integrated and successful health care system for inmates. [31][32][33][34][35][36] In Europe this should be recommended, as problems of health and shortage of resources in prisons were described on the last report of the European Prison Observatory.…”

A Comparison of Psychiatrist Evaluation and Patient Symptom Report in a Jail Telepsychiatry Clinic

“…2 When available, face-to-face psychiatry still carries the cost of transport and the risk of escape. Psychiatry has offered services using technology for over 40 years, 3 with videoconferencing applications increasing rapidly over the last few years.…”