Texas prison psychiatrist Pradan Nathan sees up to 16 patients a day from a suburban Houston office, using an audio console, a camera and a monitor to treat inmates at two state prisons 30 miles away. Most states have turned to telemedicine to some extent for treating prisoners, often in remote areas where many prisons are located, because it allows doctors to examine them from a safe distance, Stateline reports. It enables corrections officers keep potentially dangerous inmates behind bars for treatment rather than bearing the cost and security risk of transporting them to hospitals. Because more doctors are willing to participate, it makes health care more available for inmates. Though some prisons used telemedicine as early as the 1980s, its use has dramatically increased with the arrival of improved technology, electronic medical records, and pressure to control rising medical costs. “Telemedicine is perfectly designed for prisons,” said Marc Stern, a former assistant secretary for health services for the Washington State Department of Corrections.
Owen Murray of the University of Texas Medical Branch (UTMB), which handles health care for about 80 percent of Texas inmates, is convinced telemedicine contributes to Texas's relatively low per-capita spending on prisoner health. Texas has the nation's largest prison population, about 153,000, and, says Pew Charitable Trusts, spent $3,805 per prisoner on medical care in 2011, compared to a national average $6,047. Advocates for prisoners have mixed views on telemedicine. Bradley Brockman of the Center for Prisoner Health and Human Rights, called it “a godsend and a real gift because prisoners are getting care from providers or specialists that they would have far less chance of getting otherwise.” David Fathi of the American Civil Liberties Union's National Prison Project said that while telemedicine can improve health access, too often it is used to cover over inadequate prison staffing. “Because telemedicine is less expensive, there is a tendency to use it excessively and inappropriately,” he said. “It is used not as a supplement for on-site staff but as a substitute for on-site staff.”