Telehealth and telemedicine are terms covering the practice of health care delivery using telecommunications technology. Telemedicine refers to the use of technology (often videoconferencing) to connect medical clinicians and patients who are geographically distant from each other. Telehealth is a broader category of telecommunications-based healthcare, which can include diagnosis, consultation, and treatment, but also encompasses non-clinical health functions, including transfer of medical data, education, and the dissemination of public health advisories or alerts via email or other technology. The use of telehealth and telemedicine can expand access to quality medical care and treatment in a cost-effective manner. While it is true that telemedicine can bring specific expertise to a jail or prison located in a remote area, for example, it should be noted that telemedicine is also an effective method for safely, efficiently consulting with a busy specialist who may be located in a medical center just a few miles from a correctional facility. (See Policy Statement 10, Physical Health, for more on telemedicine as a way of building treatment capacity.)

For corrections administrators, one great advantage of telemedicine is its ability to reduce costs. Telemedicine can eliminate the expense and resource allocation involved in providing secure transportation to medical facilities. Further, its convenience may lend itself to early intervention, which prevents the exacerbation of symptoms that can lead to longer and more costly hospitalization and treatment. At the same time, telemedicine can enable correctional facilities to budget the time of on-site health care professionals more effectively.

Telemedicine can also provide a critical link to community-based services, resulting in greater continuity of care than might otherwise be possible. Telemedicine makes it possible for a community health care provider to establish a relationship with a re-entering inmate who will soon be under his or her care. Telehealth techniques such as email or other web-based technology also make it possible to ensure that appropriate charts, treatment plans, and other records are exchanged in a timely and effective manner.

The President's New Freedom Commission on Mental Health encouraged the use of technology and telehealth as one of its major recommendations. The Commission also noted, however, that public and private insurers/payers generally do not adequately cover the costs of telehealth services. While policies governing the use of telehealth practices require refinement, corrections officials should make every effort to employ these technologies as an effective way to provide people in prison and jails with cost-saving, evidence-based treatment.

Example: Telepsychiatry, Texas Department of Criminal Justice and Texas Tech University Health Sciences Center

The Texas Department of Criminal Justice has contracted with Texas Tech University Health Sciences Center (TTUHSC) to provide health services to 26 adult institutions, where approximately 33,000 people are incarcerated. TTUHSC conducts approximately 2,000 telemedicine consultations per year for inmates, via closed circuit, interactive video technology. Approximately one-third of all telemedicine consultations are in telepsychiatry and telepsychology. Prior to the implementation of telemedicine, most inmates needing specialized medical care were transported from the prison to a specialist, hospital, or other facility. Each trip cost between $200 and $1,000. The use of telemedicine in appropriate circumstances has helped to save significant transportation expenses.