The doctor is in … your laptop

As technology evolves (and minds open) it seems more reasonable than ever for patients to chat with a doctor via screen. While the technology is all but status quo in the court room, some in the industry wonder why more corrections facilities aren’t...


In August 2005, Stephen Slevin of New Mexico was convicted of driving while intoxicated. What happened next is the stuff headline writers dream of.

Slevin, 58, testified he was held in solitary confinement for two years without ever being prosecuted, and was not given proper medical care (claiming he pulled his own tooth when he was denied access to a dentist) or regular medication to treat his chronic depression. News photos revealed a startling before and after: the clean-shaven, tanned man in his 50s alongside a thin, bearded, wild-eyed transformation. He looked as if he had aged about 20 years. The jury awarded Slevin $22 million in history’s single largest federal civil rights settlement involving an inmate.

In the jail’s defense, Dona Ana County spokeman Jess Williams issued a statement claiming all was not as it appeared to be. He said Slevin was offered a chance to join the general jail population, but declined. Similarly, Williams maintained that for the first five months of Slevin’s confinement, he had requested and received medical attention and purchases, after which period he refused those, too. The county reported Slevin’s 22-month stay was “entirely” in the hands of then-district attorney Susana Martinez’s office, the public defender’s office and state district court. Williams also issued this statement on the county’s website:

Medical rounds were conducted three times daily, and prescribed medications were dispensed to Slevin and other detainees. The Dona Ana County Detention Center has historically faced significant challenges in terms of treating mentally ill detainees, but the challenges were consistently addressed throughout the time Slevin was incarcerated, and the efforts continue to this day.

The tech solution

In fact, changes have been made. Inmates at the Dona Ana detention center now have access to kiosks where they can log in and communicate with medical staff, and express any concerns they may have to jail staff. In the past, inmates turned in hand-written requests to receive medical attention. This particular “Case of the forgotten man” actually speaks to a common problem many jails and prisons face. That is, the enduring difficulty in hiring and retaining qualified medical staff.

It’s not always easy to lure physicians outside of urban hospital settings to work inside rural jails; so some facilities are looking for options online. Telemedicine, which has been around since the 1990s as a way to treat patients remotely, applies video conferencing technology to health care, allowing clinicians at one site (called hub sites) to provide services to any number of clinics at distant locations (called receiving sites). Using specialized diagnostic equipment specifically adapted for use in telemedicine, clinicians can see diagnostic images, perform examinations, and hold live interactive discussions with patients and institutional health care staff. The only thing missing is extended travel times, significant threats to security and a full-time physician roaming the cells, wondering what to do with his or her down time.

Doctors behind bars

As technology evolves (and minds open) it seems more reasonable than ever for patients to chat with a doctor via screen. It’s been proven cost-effective in many a health care landscape, including hospitals, schools and nursing homes. While the technology is all but status quo in the court room, some in the industry wonder why more corrections facilities aren’t taking advantage.

“In the old days, prison health care didn’t amount to anything; prisoners were left to die and it didn’t matter much,” says Dr. E. Richard Dorsey, president of Telepsychiatry Inc. in Newport Beach, Calif. “Now federal courts have required a fairly high standard of medical services, and therefore the problem is: How do you get the technical people, doctors, nurses ... especially doctors ... to come into rural areas? Most of them don’t want to.”

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