The use of telemedicine in correctional facilities.

Abstract

Telemedicine is the use of two-way telecommunication technology, multimedia, and computer networks to deliver or enhance health care. This technological advancement is transforming the way in which prison inmates are receiving health care, provide significant implications with regard to financial costs, and ensures security of inmates and correctional personnel. Scant research exists regarding myriad issues associated with the use of telemedicine in correctional facilities. This article will provide an overview of the history of telemedicine, the application of telemedicine in correctional facilities, legal and ethical implications associated with telemedicine, the benefits and barriers related to the use of telemedicine, and current and future trends associated with its use.

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Technological advances have begun to revolutionize the ways in which correctional facilities are operated. According to Gaseau (1999), corrections officials are beginning to use technology as a manpower multiplier, and technology provides an opportunity to enhance the safety of correctional employees and the safety of prisons. Technological advances that are widely used and have been found to be effective are surveillance and security technologies, tracking and detection devices, the use of automated management technologies, and communication technologies, which include teleconferencing. These technologies have yet to impact the correctional system the way in which telemedicine has.

Telemedicine, also known as telehealth, is defined as the use of electronic signals to transfer medical data from one site to another via the internet, intranets, personal computers, satellites, or videoconferencing telephone equipment in order to improve access to health care. This may include photographs, health assessment, diagnosis, intervention, consultation, supervision, x-ray images, audio, patient records, and videoconferencing (Telemedicine Information Exchange, 1997). Telemedicine includes the use of advanced telecommunications technologies to exchange health information and provides health care services across time, social and cultural barriers and geographic locations (Reid, 1996). This mode of technology consists of a network of remote sites from which patients are presented for treatment via telecommunications to physicians located at a hub site (Perednia & Allen, 1995; Turner, Nacci, & Waldron, 1999). In the late 1980s, telemedicine was recognized as a way to reach people living in rural communities. However, this form of telecommunication has impacted every facet of the correctional system from issues associated with safety and security of prison inmates to the physical health and well being of persons incarcerated. Telemedicine can range as something as simple as two health professionals discussing a case over the telephone to a sophisticated use of satellite technology to broadcast a consultation between health care providers at facilities in different cities or states (Brown, 2000). In what follows, this article will provide an overview of the history of telemedicine, the application of telemedicine in correctional facilities, legal and ethical implications associated with telemedicine, and benefits and barriers related to the use of telemedicine.

The History of Telemedicine

The practice of medicine through telecommunications, or telemedicine was developed and fostered in the early 1960's when the National Aeronautics and Space Administration (NASA) first put men in space (Welsh, 1999). NASA continued exploring the use of telemedicine by funding telemedicine research projects in the late 1960's and early 1970's where fifteen telemedicine projects were active. One of the pioneer telemedicine projects developed by NASA to deliver health care via telecommunications was the Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC). This project allowed for health care delivery to the Papago Indian Reservation in Arizona. According to the Telemedicine Research Center (1997), the project ran from 1972-1975 and was implemented and evaluated by the Department of Health, Education, and Welfare, the Indian Health Service, and people of Papago. The targeted goal of this project was to provide health care to the isolated Papago Reservation by using a van staffed with Indian paramedics and a variety of medical instruments including electrocardiograph and an X-ray machine. The van was linked to specialists at the Public Health Service Hospital by a two-way microwave transmission (Telemedicine Research Center, 1997).