In addition to more frequent specialist sessions and shorter waiting times, telemedicine offered prisons the opportunity to select physicians who would not otherwise be available. This feature could bring new and/or better quality care to the inmates.

All three health services administrators at the Pennsylvania prisons agreed that the quality of psychiatric care was much improved with telemedicine. As a result, they either discontinued, or said that they intend to discontinue, contracts with local psychiatrists. The remote psychiatrists reportedly offered several advantages:

• They were bilingual, a clear advantage when consulting with Spanish-speaking inmates.

• They were available by telephone as needed to revise medication orders.

• They were available via telemedicine on a weekly basis, and more often if needed.

• They reportedly had better medication management skills than did local psychiatrists under contract with the prisons.