Since initiating its telemedicine program in 1994, the Ohio Department of Rehabilitation and Correction (ODRC) estimates it has eliminated 40,000 inmate trips to and from medical facilities. Thats 40,000 risks of an incident with guards or the public eliminated because videoconferencing technology made medical consultations available from within the prison.
Telemedicine is just one use of video technology in prisons. Increasingly, prisons are using video for virtual visitations, video arraignment, parole violation hearings and distance learning. In addition to its value as a public-safety tool, videoconferencing saves time and money and can prevent visitors from supplying contraband to inmates.
ODRC uses videoconferencing primarily for medical consultations with physicians at the Ohio State Medical Center and other facilities. It recently conducted its 20,000th telemedicine consultation.
"If you multiply 20,000 inmate trips by two -- a trip to the hospital and back -- thats 40,000 visits where we didnt have to have inmates on the highway," said Reginald Wilkinson, director of ODRC and president of the American Correctional Association. "Its a safety factor as well as a cost factor. Its a safety factor to our staff, to the hospital staff and to the people riding up and down freeways."
An onsite prison physician or nurse assists with the physical part of the examination, taking cues from the offsite specialist via video and relaying information, including EKG data, stethoscope data and other test data. "Its not like you would just turn the machine on and the inmates there with the doctor," Wilkinson said. "Theres a professional on both ends."
Wilkinson stressed that all of the telemedicine visits are scheduled and that emergency situations are still treated as such. "If a doctor wants to do post-op or follow-ups, then that doctor can certainly request that the inmate come to the hospital," he said. "We will always take an inmate to the emergency room for any triage situation."
Meanwhile, Pennsylvania is using videoconferencing in a variety of ways, but primarily for telemedicine. Inmate populations typically have high incidents of HIV and Hepatitis C and need specialized care. "Many prisoners are in remote, rural locations, and getting access to a specialist can be time-consuming," said Martin Horn, secretary of administration for the Pennsylvania Governors Office of Administration. "And time is money. "
Prisoners with specialized needs who are located in rural locales throughout Pennsylvania can be examined simultaneously with telemedicine. "Lets say we have a group of inmates at five different prisons that have a unique medical problem -- say its HIV," Horn said. "And lets say the best HIV expert in the state is in Philadelphia. We can have that one expert treating those five inmates at those five different prisons at one time."
Turning Judges Heads
Jurisdictions like Hampden County, Mass., are beginning to convince judges and lawyers that videoconferencing is also a viable alternative to transporting suspects and inmates to court. Despite some initial reticence, videoconferencing has been making gains every year and is proving its worth, according to Bill Fitzgerald, general counsel of legal resources at the Hampden County Correctional Center.
"We are confronted with gang involvement in western Massachusetts, and [videoconferencing] inhibits the potential for gang members to meet with [rival gang members]," he said. "[Now we can] dispose of probably 10 issues in half an hour."
However, judges and defense attorneys are still reluctant to use videoconferencing when a defendant is confronted with jail time. "We dont have trials on videoconferencing primarily because its new," Fitzgerald said. "[Judges] dont want to be in a position where some inmate is going to say that he was not fully apprised of what he was doing."
Videoconferencing is used for just about everything except trials in Pennsylvania, including parole violation hearings, re-sentencing and a new virtual visitation program. The virtual visits take place at the Pennsylvania Prison Society in Philadelphia. Like other jurisdictions that have implemented virtual visitation, there was some opposition from inmates and their families at first. That subsided when inmates realized the program wasnt designed to limit visitation. It also means the inmates dont have to go through strip searches that are necessary after in-person visitations.
The visitation program, which is funded by a $134,000 federal grant, doesnt eliminate personal visits, but allows inmates and their families who are separated by great distances to see each other via video.
One of the benefits of virtual visitation is socialization. This issue is key considering that about 98 percent of those incarcerated are eventually released. Whether its virtual visitation or distance learning, keeping the inmate in touch with the outside world is crucial.
"Every inmate is released from prison," Horn said. "Theyre going to succeed or theyre going to fail."
A national study on recidivism found that two-thirds of ex-inmates were re-arrested within three years. Horn said social skills and the ability to gain employment are keys to an inmates chances of success after release.
Ohio has a job-linkage program where potential employers take advantage of videoconferencing to interview inmates who are on the verge of release. Employers up to 200 miles away are conferenced in to the prison to interview inmates rather then drive to a prison.
Pennsylvania and Ohio are delving into distance-learning programs but say the programs can be costly. "Even though it might save money in the long run, you have to make that initial investment," Wilkinson said.
Horn said jurisdictions would have to pool their resources to make distance learning a reality. "Then you will begin to get the economies of scale that allow you to spend the money that allows interactive learning opportunities." He also said the technology is not as much of a hurdle as the content of the courses. "You dont want to just have a talking head. It has to be visually exciting. The biggest challenge to distance learning in prisons is content development."
Still, Ohio plans to expand its education program to include distance learning. "Lets say we want to expand the number of inmates we want to put in the GED program or a college-level program," Wilkinson said. "We would have a teacher in one location who could be in charge of teaching a particular course. Instead of teaching 20 inmates that might be at that prison in that classroom, we could be teaching 20 times that number with one teacher."
The employment and educational programs have an impact on recidivism, according to Wilkinson. "We know through research that there is a direct relationship between a lack of education and an increased number of people who return to prison," he said.
But the bottom line for using videoconferencing technology, Wilkinson said, is protecting the public. "Its not just recidivism reduction, its public safety because there are fewer people being victimized."