Doctors reach out to patients behind bars with telehealth

July 12, 2016
Dr. Jauch using teleheath for prisoners
Dr. Edward Jauch, in the emergency department of MUSC Medical Center, shows how he can talk to people in the Al Cannon Detention Center via telehealth. Photo by Dawn Brazell

Edward Jauch, M.D., says a night in jail shouldn’t be a death sentence. Being arrested for an alleged crime is one thing. But if the inmate also happens to have a serious health condition, he or she should get appropriate medical care. 

“We’re not talking about people who are necessarily in here for years and years,” Jauch says. “This could be any unfortunate encounter and you’re down there without your meds or somebody has a sudden emergent medical condition. Being in jail even briefly should not risk your health or even your life for what should have been a 24 hour bailout.”

Jauch, director of the Division of Emergency Medicine at MUSC Medical Center, says a new partnership between MUSC Health, the South Carolina Department of Corrections and Charleston’s Al Cannon Detention Center will help ensure inmates who need medical expertise have access to it.

While the prisons and jail do have medical care, it’s not always offered 24/7. MUSC Medical Center has doctors working around the clock.

But the new partnership doesn’t mean more inmates will be showing up at MUSC Medical Center for care. In fact, fewer will. Thanks to telehealth, which connects health care providers with patients through technology, including video, inmates can see doctors without leaving jail or prison. They only visit MUSC Medical Center if an in-person visit is warranted.

Edward O’Bryan, M.D., one of the emergency department doctors who handle inmate appointments, says they aren’t the only ones who benefit. 

“For taxpayers, it makes a lot of sense. Every time a prisoner is sent out of the prison, it’s not just the cost of the doctor visit,” O’Bryan says. “It’s the cost of two guards who have to be with the prisoner at all times, plus a guard to transport the prisoner.”

That can quickly add up to hundreds or even thousands of dollars.

Bryan Stirling, director of the state Department of Corrections, says prison telehealth also protects the public. “This initiative promotes public safety by limiting offender transports outside of prisons.”

The Kirkland, Evans, Turbeville and Lee Correctional Institutions are the first of the state’s 23 prisons to be involved in telehealth through MUSC Health.

While telehealth can provide life-saving consultations in a crisis, it can also be used to address simpler issues. It’s a way for inmates just coming into the prison system to get the required physical exam quickly if no prison doctors are available. That allows them to move on to their assigned prisons and begin serving their sentences.

O’Bryan says telehealth is also a good way for inmates with chronic conditions to see doctors on a regular basis. “A lot of people ask why we’re bothering with prisoners. The downstream effects of not treating the prisoners with the best health care possible in prison are worse on the health care system. If you let things fester, when people get out it will still be a burden on society to care for them but it will be in the emergency departments.”

The prison and jail telehealth program is part of a larger effort at MUSC Health to reach underserved people across South Carolina through its Center for Telehealth. The idea is to get good medical care to people in rural parts of the state, including prison towns. Research suggests that telehealth works as well as in-person appointments for many health issues. 

O’Bryan says so far, the inmates he’s seen seem to be fine with telehealth. He hopes that over time, they’ll come to realize the value of having one-on-one time with an MUSC Health doctor as opposed to a busy jail or prison doctor or nurse. “I want them to feel like they’re cared about more than they thought was possible in jail or prison.”