U.S. Department of Justice
Office of Justice Programs
National Institute of Justice

Research Report - March 1999

Acknowledgments

Summary

Chapter 1: The Telemedicine Demonstration

• The Demonstration's Rationale
• Implementing the Demonstration

• Teleconsultations Substituted for and Supplemented Conventional, In-Prison Consultations
• Telemedicine Reduced External Visits to Specialists
• Telemedicine Averted Costly Transfers to Federal Medical Centers
• Summary

• Implications of These Findings for Expanding Telemedicine to Other Prisons

• Shorter Waiting Times
• Quality of Specialists
• Access to New Specialists
• Acts of Violence and Use of Force
• Grievances
• Summary

• Internal Specialist Encounters
• External Specialist Encounters Averted
• Psychiatric Transfers Averted
• Telemedicine Encounters
• Waiting Time
• Incidents and Grievances
• Descriptive Information

• Capital Costs
• Fixed Operating Costs of Telemedicine
• Transfers to Federal Medical Centers
• External Consultations
• Cost of Direct Internal and Telemedical Consultations

Appendix D: Cost of the Telemedicine Demonstration

• Costs per Encounter

Figures

Figure 1.1:		Number of Telemedicine Consultations for All Specialties Combined, per Month and by Facility, 9/96 - 12/97
Figure 1.2:		Number of Telemedicine Consultations for All Four Prisons Combined, per Month and by Specialty, 9/96 - 12/97
Figure 2.1:		Number of Conventional In-Prison and Telemedicine Consultations for Four Specialties in All Pennsylvania Prisons, 10/95 - 12/97
Figure 2.2:		Number of Conventional In-Prison and Telemedicine Consultations for Four Specialties at USP-Lewisburg, 10/95 - 12/97
Figure 2.3:		Number of Conventional In-Prison and Telemedicine Consultations for Four Specialties at USP-Allenwood, 10/95 - 12/97
Figure 2.4:		Number of Conventional In-Prison and Telemedicine Consultations for Four Specialties at FCI-Allenwood, 10/95 - 12/97
Figure 2.5:		Average Number of Conventional and Telemedical Consultations per Month and by Specialty, Before and During Demonstration

Tables

	Table 2.1:		Savings Accrued From Averting Transfers to Federal Medical Centers
	Table 3.1:		Comparison of Average Monthly Cost and Savings of an Operational Telemedicine System and Conventional Care (Based on 100 Internal Specialist Consultations)
	Table 4.1:		Average Waiting Time Between Referral and Initial Consultation With a Specialist, Before and After Introduction of Telemedicine, by Specialty
	Table C.1:		Number of Telemedicine Encounters per Month, by Specialty and Facility
	Table C.2:		Number of Conventional, In-Prison Specialist Encounters per Month in Three Pennsylvania Prisons During the Predemonstration Period (Principal Specialties Only)
	Table C.3:		Number of Conventional, In-Prison Specialist Encounters per Month in Three Pennsylvania Prisons During the Demonstration Period (Principal Specialties Only)
	Table C.4:		Conventional, In-Prison Specialist Consultations: Medical and Indirect Expenditures at Three Pennsylvania Prisons During the Predemonstration Period (Principal Specialties Only)
	Table C.5:		Conventional, In-Prison Specialist Consultations: Medical and Indirect Expenditures at Three Pennsylvania Prisons During the Demonstration Period (Principal Specialties Only)
	Table C.6:		Estimated Costs of Bus Transportation From FCI-Allenwood to USP-Allenwood for Telemedical Consultations During the Demonstration Period
	Table C.7:		Estimated (Weighted) Average per-Inmate Costs of Air Transfer From Three Pennsylvania Prisons for Psychiatric Purposes During the Demonstration and Predemonstration Periods
	Table C.8:		Estimated Average per-Encounter Cost of External Specialist Consultations at Three Pennsylvania Prisons by Cost Element, During the Demonstration and Predemonstration Periods
	Table C.9:		External Consultations: Estimated Average per-Encounter Indirect Costs for Administrative Staff Only
	Table D.1:		Fixed Monthly Costs of the Telemedicine Demonstration
	Table D.2:		Variable per-Encounter Costs Associated With the Telemedicine Demonstration
	Table D.3:		Comparison of Average Monthly Costs of the Demonstration Telemedicine System and Conventional Care (Based on 100 Internal Specialist Encounters)
	Table E.1:		Amortization of Capital Investment