NYC Health + Hospitals has launched a program to provide telehealth services to female prisoners on Rikers Island, expanding a service aimed at reducing the costs and disruption associated with transporting prisoners to a medical facility.
NYC Health + Hospitals/Bellevue launched a similar initiative for the male population at Rikers in May 2016 with the system's Correctional Health Services arm. Building on the success of that program, the system’s Elmhurst facility launched a telehealth service for female patients earlier this year.
Telehealth is frequently touted for its convenience for the general population, but the impact is amplified for incarcerated patients that require at least two correctional officers, along with additional transportation considerations. In a 2017 study, University of Chicago researchers found that telemedicine can provide a new avenue for specialty care for prisoners that have traditionally lacked consistent access to medical services.
For the hospital, it’s a way to streamline operations, cut down on missed appointments and improve care for patients that frequently forgo medical care because of the time it takes to see a provider in person.
“I think what it’s going to do is cut down the amount of time in the clinics,” Joseph Lieber, M.D., a diagnostician and clinical educator at NYC Health + Hospitals/Elmhurst, told FierceHealthcare. “Frankly, it’s going to make patient satisfaction better. It’s a long ride to get from Rikers and you have to get in a van with two officers for a visit that might be able to get done in 15-20 minutes.”
Much of the technological infrastructure was already in place at Elmhurst, Lieber says. The medical team at Rikers found a room and brought in the proper equipment. A member of the Rikers medical staff is in the room during the telehealth visit. Elmhurst, which has been on Epic’s EHR platform since April 2016, can easily share medical records with Rikers, which is on the same system.
Rheumatology, oncology and hematology are among the services currently offered virtually, and the system has plans to add gastroenterology and infectious diseases in the near future. Lieber says dermatology, recently added to the list of specialties provided to male inmates at Bellevue, is particularly promising given the reliance on visual assessments.
Last year, Bellevue used telehealth to treat Rikers patients during 469 visits.
While some patients may require a face-to-face visit, Lieber expects the majority of specialty care for women at Rikers to shift toward the virtual model.
“When I speak to specialists they say maybe eight or nine out of 10 visits can be done [via telehealth],” he said. “Many of my specialists felt that once the patient is there and we have records, a lot of could be done with telehealth, especially because there is a medical professional on the other side.”