Telepresence Services Improve Patient Care and Legal Access at the Department of Corrections

October 12, 2022

By Danielle Jimenez (email) Department of Corrections

With the onset of the COVID-19 pandemic, the Washington State Department of Corrections (DOC) launched into meeting the needs of its incarcerated population through telepresence services. With patient care and access to health care as a priority, the agency installed telehealth services in all 12 of its prison facilities in December 2021.

With telehealth services, the DOC’s goals include improving appointment-wait and-travel times and improving medical care for incarcerated individuals, said DOC Assistant Secretary of Health Services David Flynn. This initiative provides greater accessibility to care, faster service, and a more streamlined, modernized health care platform for patients, he added.

"I am truly excited that we can enable specialists and primary-care providers remote access to provide treatment to those in our care and custody," said DOC Deputy Secretary Sean Murphy. "This is about bringing incarcerated individuals responsible and timely care. It is also about keeping our staff and the community safe. For me, it’s a win-win."

Telehealth is the emerging trend in health care everywhere. With the onset of COVID-19, telehealth visits became a norm for many and allowed patients to have better access to care, to be seen safely, quickly, and efficiently at a time when many were sheltering in place to reduce the spread of the virus.

"When COVID hit we knew telehealth was definitely needed, and once we got it, it was really appreciated," said DOC Chief Nursing Officer Rae Simpson. "It allows us to talk to many different specialists in the community to prioritize and get our patients treatment."

Telehealth visits have become a staple in medicine and now incarcerated individuals at the DOC share the benefits of telemedicine that have become essential for so many across the globe.

"We have talked about implementing telehealth for a while, but with community providers moving more towards telehealth consults, when possible, we wanted our patients to have improved access to health care providers in the community, and telehealth will give us that improved service," said DOC Chief of Staff Julie Martin.

When an incarcerated individual requires medical care, they now have areas at each of the facilities with a designated station as well as options for appointments on tablets that come to them.

"We’ve also purchased telehealth carts and tablets that are able to go to a patient’s room and they’re Wi-Fi capable – if vitals are needed, nurses are able to assist as well," David Flynn said. Having the ability to bring a tablet directly to a patient is game changing for incarcerated individuals and health care providers — especially with the pandemic still top of mind at the DOC, Simpson said.

"I can tell you with the impact of COVID, telehealth has allowed patients to reach out and be seen more quickly; especially for mental health concerns," Simpson said. "They can talk to their counselors right on tablets we bring to them. When you’re in medical isolation or quarantine that limited socialization will increase mental health challenges so having quick access to care is important. The patient can’t always go to providers in the community, but the provider can go to the patient."

At facilities, incarcerated individuals have what’s called a "kite process", which is a communication between the patients and providers that’s always available, Simpson said. If they declare an emergency – such as a mental health emergency – they can be seen by a mental health professional right away.

In the past, when specialized medical care was required, incarcerated individuals had to be transported outside the secure perimeter of the prison to external medical facilities. Telehealth allows improved health care by providing quicker access to more medical specialists.

Telehealth will assist in expanding health care programs for incarcerated individuals and will lead to shorter wait times, increased patient privacy, and improved outcomes for the incarcerated population.

For incarcerated individuals who have chronic conditions, getting swift, regular access to a specialist can mean major improvements in their health. Before telemedicine, the logistics of getting that access was more complicated.

In many cases, incarcerated individuals who required specialized care had to leave the prison to access it. In some areas, this could mean several hours of travel, complicated even more by the security concerns that come with taking incarcerated individuals out of prison. They must be escorted to appointments by corrections officers, which can sometimes create a bottleneck for others also waiting to travel to a specialist.

"It helps us be current with the rest of the industry, and there’s barriers to people being seen by outside providers and this eliminates a lot of those – and it aligns with reentry as well," David Flynn said. “They go to their telehealth appointment and can interact with a provider in the community like you or I. Its working towards being more patient centered."

Telehealth in prisons significantly streamlines incarcerated individuals’ health care. Patients who’d been traveling offsite for care only need to leave the prison for appointments that require in-person care from a specialist— like surgery. And physicians who previously had long travel times and had to navigate significant security to see patients onsite at the prison, can see their patients right from their office.

"Telehealth allows us to reach out to more providers and specialists, and it allows us to bridge out to the community and get the services our patients need," Simpson said.

It enables them to receive specialist care more quickly, and specialists can see significantly more incarcerated individuals, Simpson said.

"The department would like to expand the use of technology where it fits – to improve access, enlist specialty services in the remote location of our prisons and provide quality care for the 21^st century," Murphy said. "This will be vital as our environment continues to evolve battling COVID-19 and other infectious diseases. This is the right time to make this happen."

Telemedicine is not the only way the DOC is using telepresence services at its facilities.

Lisa Flynn, correctional program administrator for Correctional Operations, added that the agency’s ability to expand telepresence services related to legal access, reentry, and services for incarcerated parents has been phenomenal.

Now, the DOC is seeking permanent funding to allow for continued and expanded use of telepresence technology.

External stakeholders offer strong support of the new telepresence services for not only telehealth, but for court hearings/resentencing, child dependency issues, child support abatement hearings and reentry services, Lisa Flynn said.

The demand for virtual-court appearances continue to grow. Not only due to court decisions and legislative actions impacting sentencing, but also due to criminal-justice partners moving to safer virtual platforms to complete court actions formerly done in person, to keep communities safer and reduce costs associated with external transports, Lisa Flynn said.

With more telepresence options, incarcerated parents can participate in dependency actions involving their children, giving them a voice in the care and welfare of their children.

Telepresence technology is critical in allowing parents to remain connected and involved in decisions regarding their children during incarceration and supporting family reunification efforts, Lisa Flynn said.

"Department of Corrections will continue to work with criminal-justice partners and stakeholders to increase efficiency and improve access to services essential for the health and well-being of incarcerated individuals," Lisa Flynn said. "In doing so, we create pathways for positive outcomes for these individuals, supporting our mission to ‘Improve public safety by positively changing lives.’"