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South Carolina’s Prison Telehealth Deal is About More Than Healthcare

The project to provide telehealth services to four state prisons will improve inmate healthcare, reduce costs and cut down on security risks throughout the community.

By Eric Wicklund

- A telehealth project designed to serve South Carolina’s prison population could save the state thousands of dollars a year in healthcare costs – and that’s not the only benefit.

In a partnership announced this month by the South Carolina Department of Corrections, the Medical University of South Carolina (MUSC) will be deploying telemedicine carts to four state prisons. Once established, clinicians at the Charleston-based health system will be able to examine inmates at any time via video feed, collect vital signs, make diagnoses and prescribe medications.

The project is being shepherded by Ed O’Bryan III, MD, global health director and TeleEmergency lead for MUSC’s Division of Emergency Medicine, who’s now using the platform to treat prisoners at two local jails. He’s beginning with an emergency care platform that focuses on healthcare issues that would normally be treated by sending an inmate to the local hospital ER, but expects to expand the platform to address chronic care (including HIV and AIDS) and telemental health.

“My ideal is that no inmate should be transported out (of the prison or jail) for anything that can be accomplished through telemedicine,” he says.

O’Bryan says the program will go far beyond reducing the state’s annual bill for inmate healthcare, which currently runs to almost $3,000 per inmate. Each telehealth encounter that negates the need for transport to a local hospital saves thousands of dollars in healthcare costs, reduced ER crowding and security concerns at the hospital, and staffing and security costs incurred by the prison when an inmate is transported elsewhere.

“Utilizing telehealth services allows the agency to provide care to offenders while offsetting the cost to taxpayers with fewer trips to outside providers,” Bryan P. Stirling, the SCDC’s director, said in a July 5 press release. “This initiative promotes public safety by limiting offender transports outside of prisons.”

Not to mention the improved clinical outcomes.

Telehealth platforms for prisons have been gathering momentum around the country, with states like New York, Mississippi, Texas, Florida and Colorado among the front-runners. Those states are looking to cut into the $7.7 billion spent each year on inmate healthcare around the nation, which accounts from about 20 percent of the country’s corrections costs. In addition, a 2014 report from The PEW Charitable Trusts and the John D. and Catherine T. MacArthur Foundation found that per-inmate healthcare costs rose by a median of 10 percent from fiscal 2007-11.

O’Bryan says the platform is fairly easy to scale, with the biggest challenges being training staff to use the technology, accounting for extra security measures and making sure everything on the telemedicine cart is accounted for at the end of the day. And while its might be hard to judge the success of the platform based on patient engagement - “it’s pretty hard to do patient satisfaction surveys in that environment,” he says – similar program have seen success in a reduction in inmate grievances.

The prison telehealth program continues an impressive array of platforms for MUSC, considered one of the nation’s leading digital health providers.

“Telehealth is poised to improve the health of all South Carolinians, and this connection is a significant advance furthering that mission,” James McElligot, MD, MUSC’s telehealth medical director, said in the press release. “The technologies, when wisely applied, can transcend the significant challenges in providing care to this population and have tremendous potential for cost savings to our state. This effort is yet another example of how our state legislature’s vision and support has enabled telehealth services to be developed and deployed efficiently.”

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