Tennessee Prisons Providing Remote Medicine

The initial applications will be for ear-nose-throatexams, infectious diseases, dermatology and generalsurgical follow-up.
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Delivering medical services to prison inmates is never simple. In Tennessee, the Department of Correction has recently placed telemedicine gear in clinics in all of its prisons, and is bringing on line a system to let doctors reach patients around a large state without burning time and money on travel.

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A TDOC inmate gets an ear exam with a remote doctor. TDOC is building on its legacy videoconferencing system, with limited use for actual medical care, and with cost issues related to phone use.

The top goal of the department is safety, said Donna White, TDOC director of health services. So it tries to provide as many services behind the prison walls as possible, moving to outside facilities only when no other alternative is possible.

The previous system enabled about 75 telemedicine consults a year. The new system, which TDOC expects to be fully operational in July, would handle many more. The state has a fresh contract with Correctional Medical Services and is in the process of lining up specialists.

The way it would work is that a nurse or other practitioner onsite would use medical audio-visual tools from AMD Global Telemedicine—stethoscopes and specialized cameras for looking at wounds, into ears and throats, and so on. A doctor in another facility would see a split screen with a view of the patient and nurse in one field and the output from the AMD cam on the other. In the prison, the inmate and nurse also get the split screen.

The doctor can ask questions; the nurse onsite can adjust and operate the camera.

The initial applications will be for ear-nose-throat exams, infectious diseases, dermatology and general surgical follow-up. Cardiology consultation could also be in the mix, as could telepsychiatry. In all cases, the doctors can assess if the inmate needs to be elevated to a higher level of care.

TDOC figures the system will be popular inmates. Many don’t want to be transferred across the state, as they can temporarily lose cell assignments, prison jobs and control of their possessions. Also, once transferred to a different facility, they may have to wait in administrative segragation (solitary confinement) until the facility figures out a cell assignment. So some patients have opted to refuse such treatments against medical advice.

The Tennessee system uses a Tandberg Edge 85 HD video conference system, with audio/video devices including the AMD-2500 General Exam Camera , the AMD-400S camera/illumination with the AMD-2015 ENT/Otoscope, and the AMD-3100 Ausculette II electronic stethoscope.

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