Best practices and telehealth

Best practices and telehealth

Karey Witty, CEO

Last month in this space, I wrote about how our business need not fear recent efforts to eliminate private prisons. I argued that providing healthcare behind bars is too complex – and becoming more so every day – for law enforcement and corrections agencies to manage within their core missions. The challenge for us is not whether jails and prisons will outsource their correctional healthcare needs, but how to ensure they continue choosing Corizon Health as their partner.

Since we’re in the final days of a presidential election, it seems appropriate to describe the current market in which we compete using a political analogy. Corizon Health is the incumbent. We have been in the field for decades, we have a track record, and our clients and potential clients – the “voters,” if you will – think they know us. Our competitors are much like political challengers who, without a record to defend, are free to make promises to the voters that they may not be able to keep.

I proposed our Core Process program as one way for us to live up to the commitments we make to our clients. These represent best practices and are standard operating procedures for our clinical staff to follow in every patient encounter in every Corizon facility across the country.

Across-the-board clinical excellence is vital to our long-term success, but it is only part of the value we must demonstrate to our clients to continue winning their votes. We also must bring solutions to the challenges our clients face. The greatest of these challenges is meeting the increasingly complex – and expensive – healthcare needs of inmates, which are outpacing correctional budgets.

According to the 2014 report “State Prison Health Care Spending,” by the State Health Care Spending Project, from 1999 to 2013, the number of state and federal prisoners age 55 or older increased 234 percent while the inmate population younger than 55 grew only nine percent. The cost of incarcerating these older inmates is estimated to be two to three times higher than all other inmates, yet state correctional healthcare budgets have been steadily decreasing after peaking in 2009.

The decline in state correctional spending has helped drive privatization as governments seek to save money by shedding pension liabilities and the cost of employee benefits while seeking to improve the overall health outcomes of our patient population. But if current trends continue, governments will look to their private partners to find more savings.

I believe telehealth is one solution to meeting our patients healthcare needs while respecting our clients budgetary challenges.

At Corizon Health, we have been using telehealth for seven years. With more than 175 telehealth endpoints providing care throughout the company, our use of the technology has increased in recent years. For example, in 2015, we administered more than 38,000 telehealth encounters. Of those, 4,600 would have required transportation to an off-site location, resulting in a savings of nearly $1.3 million.

In the beginning of 2016, we began upgrading our internal telehealth technology infrastructure allowing for increased use across our many sites. As of the end of September 2016, we already have completed more than 39,000 telehealth visits, significantly outpacing our 2015 numbers.

Telehealth isn’t only helpful as a cost-savings solution for our clients. In the midst of a well-documented shortage of mental health providers, telepsychiatry and telepsychology have allowed us to bring critical services to our patients in under-served areas, who suffer rates of mental illness far higher than the general public. Consider: The Bureau of Justice Statistics estimates 73 percent of women and 55 percent of men in state prisons suffer mental health problems while in jails the numbers are higher at 75 percent and 63 percent respectively. Telehealth – or in this case telepsychiatry – allows a single doctor to provide behavioral health services to several prisons, which often are located in rural areas far from each other and major metropolitan areas. In 2015, we conducted over 26,000 telepsychiatry visits.

The potential for telehealth far exceeds behavioral health applications. With the assistance of a nurse or prison provider, and utilizing sophisticated peripheral instruments attached to a computer unit, patients may interact with specialists in areas such as cardiology, endocrinology, ENT, general surgery, infectious diseases, nephrology, ob/gyn, orthopedics, and urology.

Telehealth is not appropriate for all specialty services. While we’ve had some clients who reject or disapprove of telehealth solutions, we have others who believe almost all off-site trips should be avoided through telehealth. It is incumbent upon us as correctional healthcare experts to educate our clients about this promising technology, and to continually work to partner with local hospitals and clinics to bring specialty care to our patient population in the most appropriate way possible, whether through off-site visits, on-site clinics or via telehealth.

While it is a solution we readily propose when appropriate, it is not a panacea to avoid transportation and security costs and public safety risks. Not only is the basic equipment expensive to purchase and costly to maintain, many medical specialties employ specific instruments that have to be added to the system. The demand for the specialty, along with the availability of that service in the community, must be evaluated to determine if the cost makes sense.

Telehealth is one leading-edge solution to the challenges of healthcare access and rising healthcare costs; not only inside the walls but throughout society. I am proud that we are in a position to demonstrate the viability of this solution inside and outside of corrections. As the leader in correctional healthcare, this is just one of the many best practices Corizon Health brings to our clients.

by: Karey Witty, CEO