In a Kentucky prison, a physician takes pictures of an inmate's back, which is covered in a large rash. Typically, an offender with a rash would be transported to a specialist for a consultation. But in Kentucky, this doctor can simply click “send” on his PC and specialist consultations are at his fingertips.

“If an inmate needs a consultation with a dermatologist, we no longer have to shackle them and escort them to an appointment,” says Scott A. Haas, Medical Director for the Kentucky Department of Corrections (DOC). “Electronically, our practitioners can send their entire consultation request to the dermatologist, including photo and video footage on their PC tablets.”

Recently, the Kentucky DOC, the University of Kentucky and CorrectCare, a health management firm, joined forces to improve the quality of inmate health care in a cost effective way. Among a number of initiatives, corrections practitioners there are now using wireless PC tablets to address the health care needs of inmates -- and keep track of their medical records.

Using this technology, corrections practitioners can keep track of everything from allergies to prescriptions, automatically updating each inmate's records as they make their rounds. Each PC tablet is connected to a server that contains the medical history of each inmate, and the information is accessible wherever there is an Internet connection.

But one of the most important features allows physicians to route audio and video footage to specialists for e-consultations, reducing the costs and security risks associated with transporting inmates to medical appointments. The DOC estimates that costs for medical trips will be reduced by about 50%, saving about $350,000 annually. According to Haas, the PC tablets also offer quicker results, ensuring timely health care for inmates.

“Normally, it could take anywhere from two to six weeks for a consultation especially considering how long it takes to get an appointment,” says Haas. “Now, we're estimating that it will take anywhere from two to 10 days.”

With quicker consultations, reduced costs, and increased security, the Kentucky DOC is moving forward with its newest health care initiatives.

Moving Forward and Maintaining Quality

While the DOC looks ahead with new, cost-effective technology, it has not lost sight of the need for quality health care. Without this system, the Kentucky DOC would have to send more inmates out for specialist consultations and treatment.

“Obviously, we don't use this technology for every case of illness,” says Lisa Lamb, Director of Communications for the DOC. “We still take the inmate out of the institution when it's needed. But with this technology, we can eliminate at least one trip to the doctor – and save those trips for the inmates who need them most.”

From a practitioner's point of view, the new PC tablets aren't just reducing security risks. They are also making it possible to see more inmate patients, update inmate records seamlessly, and become more mobile.

“Before this technology, we had a medical services building. We had a few computers that every practitioner used to update inmate information after a consultation,” says Haas. “But that was time consuming, and it slowed us down. We couldn't put a computer in every consultation room – we'd have more computers than providers if we did that. So by switching to a wireless PC tablet, we're allowed to move from our offices to any of the exam rooms without cables, wires, papers or pens.”

The new mobility factor also allows practitioners to take their PC tablets into segregated housing units, which Haas says increases efficiency and allows for a faster visitation rate.

Designing a New Health Care System

The PC tablets, which were commercially available and customized to fit the health care needs of the DOC, rely on a user identification and password system to ensure secure information. Haas says that log-on credentials dictate how much information is available to each user. For instance, a classification officer would have access to an inmate's name and medical appointments for additional verification. However, a medical provider has access to the full medical record of each inmate and anyone with administrative rights can access the record and modify the information as needed.

“At first, I wasn't sure how the security aspect of the PC tablets would unfold,” says Haas. “But the log-on credentials have worked out really well; the people who need the information have it. This keeps the record for the eyes of the people who should have access to it. Before this system, there was no way to know who had access to an inmate's medical history.”

The specialists on the receiving end of the PC tablet information also benefit from the new system. Typically, whenever a specialist receives a request for an e-consultation, they simply review it when they have the time. This leaves the specialists free to continue with their scheduled appointments, prioritize, and gives them a chance to review inmate cases when time allows. Meanwhile, the DOC continues to benefit because e-consultations are cheaper than physical appointments.

“An e-consultation is about $80,” says Lamb. “It's about half of what a typical visit would cost. It's great for the inmate because it takes longer to secure an appointment than it does to do it all online. We've decreased the time it takes for them to get an expert diagnosis and we've decreased transportation costs.”

But the DOC hasn't stopped there. Looking ahead, Haas says there are plans to roll out an extension of the PC tablet – into the realm of prescription medicines.

“One thing that is up and coming within the next six months is that we are going to integrate our electronic medical record with an electronic medical ordering program,” Haas says. “Practitioners will be able to order prescriptions for inmates over the PC tablet, and that will go directly to the pharmacy.”

As technology helps corrections practitioners make faster rounds, improves security and reduces costs while still maintaining quality health care, Haas is optimistic that wireless PC tablets are the future.

“There are a few other states out there with various versions of electronic medical records,” Haas says. “But we are among the leaders in terms of how we are implementing and using the technology.”