Elizabeth A. Krupinski, PhD - PowerPoint PPT Presentation

1 / 23
About This Presentation
Title:

Elizabeth A. Krupinski, PhD

Description:

Elizabeth A. Krupinski, PhD Arizona Telemedicine Program Reception center staff evaluates each inmate on substance abuse, education, mental health, and medical. – PowerPoint PPT presentation

Number of Views:361
Avg rating:3.0/5.0
Slides: 24
Provided by: Elizab50
Category:

less

Transcript and Presenter's Notes

Title: Elizabeth A. Krupinski, PhD


1
  • Elizabeth A. Krupinski, PhD
  • Arizona Telemedicine Program

2
  • Reception center staff evaluates each inmate on
    substance abuse, education, mental health, and
    medical. Initial classification for placement in
    state institution conducted and finalized prior
    to movement.
  • Inmate may be held at reception center for gt 10
    days if inmate has special medical needs or other
    special circumstances such as pending
    extradition.

3
  • 1 to 5 scoring system. Most important factors
    that determine final score placement are public
    risk, institutional risk medical needs.
  • Scores establish custody level need for
    specific services such as medical, mental health,
    substance abuse or sex offense treatment, and
    program needs including education, vocation
    training work skills.
  • Relocation based on bed availability in
    appropriate custody level medical rating of
    inmate and facility.

4
  • Comprehensive medical, dental, mental health
    services considered medically necessary.
  • Ongoing treatment by licensed professional
    (physicians, PAs, NPs) plus nurses, lab
    technicians, pharmacists, radiology techs. All
    phases dentistry including oral surg
    restorative. Mental health assessment, crisis
    management, therapy.
  • Emergencies facilitated through area hospitals.
    Specialty services provided through contracts
    with Board eligible or Board certified
    specialists in community by direct contact or
    video conferencing telemedicine.

5
  • If inmate requests medical attention may submit
    written Health Needs Request (HNR) to Medical
    Unit. Request reviewed inmate scheduled if
    necessary. If request urgent or life threatening,
    inmate seen immediately.
  • All medical information is considered privileged
    and highly confidential.

6
  • Health care recommended provided at local
    facility level by local providers. If specialty
    services/consultation recommended, request
    forwarded to Health Services Central Office.
  • Only procedures/treatments considered absolutely
    medically necessary considered for approval.
    Cosmetic or elective in nature will not be
    approved. Final determination for any treatment
    plan decision of AZ DoC medical staff.

7
  • Charge up to 5.00 when scheduled after
    submitting HNR, or on emergency basis.
    Appointments requested by a health care provider
    there is no charge. Chronic serious medical
    conditions (diabetes or hypertension) followed on
    routine schedule without HNR no charge.
  • Prescription medications supplied as necessary.
    Certain OTC medications (ibuprofen or
    multi-vitamins) available at inmate store.

8
St. Marys Hospital
  • Carondelet Health Network Southern AZs oldest
    largest non-profit HC provider.
  • Heart and Vascular
  • Neurology and Neurosurgery
  • Womens Care Services
  • Orthopedics and Rehabilitation
  • Burn and Wound
  • American Diabetes Association Recognized Diabetes
    Care Centers
  • Hospice and Palliative Care
  • Diagnostic and Surgical Services
  • Outpatient Services
  • Lifeline Emergency Response Helicopter Program
  • Contracted Services for Correctional Care
  • Long-term Care Facility in Nogales, Arizona

9
St. Marys Hospital
  • March 1998 ATP provided TM services
  • Continues to present ( 120 consultations)
  • St. Marys started March 2000
  • Main referring site both IP TM
  • SF 649
  • RT 12,847
  • Total 13,496
  • Mental Health services not included (gt 7000)
  • Tandberg Healthcare System 3 codec 5000
  • Transitioning to Second Opinion

10
(No Transcript)
11
(No Transcript)
12
Type Type Type
Orthopedics 2830 Neurology 289 Plastic Surg 47
Renal 1868 Oral Surgery 287 Nephrology 32
GI 1419 Internal Med 231 Physical Therapy 19
Urology 1351 Dermatology 183 Dental Surgery 6
Cardiology 1219 Pulmonology 170 Oral 5
Surgery 1083 Hand Th/Surg 155 Podiatry 5
Hem/Onc 1007 Rheumatology 115 Cardiac Surgery 3
ENT 621 Infec Dis 94 Speech Therapy 3
Neurosurgery 403 Vascular Surgery 49 Thoracic Surgery 2
13
  • Scenario 1 - Medical Center Visit Average cost
    per case 849.90
  • Scenario 2 - Telemedicine Visit Average cost
    per case 467.25
  • Savings per case 382.65

14
  • US Department of Justice 2002
  • Implementing Telemedicine in Correctional
    Facilities
  • www.ncjrs.gov/pdffiles1/nij/190310.pdf
  • Executive Summary
  • Introduction
  • Implementation Decision Planning
  • Technology Evaluation
  • Cost Estimation Model
  • 8 Appendices with worksheets

15
Whats Being Done?
Site/ Program Site/Program Site/Program
California Johns Hopkins (MD) Kentucky
Georgia Carolinas (NC) Louisiana State
Northwest TH (Wash.) UC Davis (CA) Iowa
NSW TH (Sydney) Mountaineer (WV) Western Australia
Virginia Commonwlth UTMB (TX) TX Tech
Maine Crozer (PA) University VA
Wisconsin ECU (NC) University AZ
SUNY Buffalo (NY) FFACTS (TX)
16
Whats Being Done?
Specialty Specialty Specialty Specialty
Derm 16 Ortho 7 Oncol 4 Burn 2
Infec Dis 14 Nephrol 7 Wound 3 Dental 2
MH 14 HH 6 Renal 3 Anesth 2
Neuro 12 Radiol 6 Spch th 3 Hand Surg 1
Card 10 Surg 6 Pulm 3 Forensic 1
Peds 8 Rheum 6 Urol 3 Audiol 1
Gastro 8 Pain 5 Path 2 ALS 1
Int Med 8 ObGyn 5 Nutrit 2 Post Surg 1
ER 7 Rehab 5 Pub Hlth 2 Plastic Surg 1
Endoc 7 Primary 5 Anesth 2 Pharm 1
Ophthal 7 ENT 4 Podiatry 2 Vasc Surg 1
17
Ob/Gyn _at_ Univ Arkansas
  • 6 incarcerated women are pregnant
  • Often at high risk (drugs, alcohol, smoking)
  • 1.4 Mbit T1 with 512 Kb video capability
  • Multi-disciplinary
  • Generalist Ob/Gyn
  • Maternal-Fetal Medicine Specialist
  • Genetic Counselor
  • Sub-Specialists (radiology)
  • Labor delivery

Gordon Low Pregnant Incarcerated ATA 2008
18
Ob/Gyn _at_ Univ Arkansas
  • High patient clinician satisfaction
  • 41 pregnant patients served
  • 224 patient visits
  • 20 deliveries
  • 56 triage calls
  • 14 transport calls

Gordon Low Pregnant Incarcerated ATA 2008
19
Derm _at_ Fletcher Allen (VT)
  • Video based consulting
  • 2002 2005
  • 668 DoC consultations
  • 78 new
  • 244 Community based consultations
  • 59 new

20
Derm _at_ Fletcher Allen (VT)
  • Most common diagnoses both groups
  • Acne
  • Psoriasis
  • Dermatitis
  • Next most common non-TM services
  • Basal Cell Carcinoma
  • Actinic Keratoses
  • Only 0.4 for TM groups

21
Derm _at_ Fletcher Allen (VT)
  Prior Diagnosis Change Diagnosis Prior Treatment Change Treatment
Corr 48 20 74 83
Comm 66 7 73 67
22
  • TM has clear significant role in corrections
  • Likely are programs without documented
    descriptions or outcomes
  • Numerous clinical specialties can be covered
  • Clearly some more common than others
  • Cost-benefit analyses generally show savings
  • Mainly due to reduced transportation costs
  • Secondarily to reduced physician travel costs
  • Outcomes data are scarce but likely positive

23
THANK YOU!
Write a Comment
User Comments (0)
About PowerShow.com