Telemedicine: contributions, difficulties and key factors for implementation in the prison setting

Abstract

Information and communication technologies are transforming the way we understand health, via a hyper-connected world in which patients, professionals and society take on new challenges and roles. This change is creating an ecosystem called connected health, in which telemedicine acquires special importance when distance (not only geographical), is a critical factor. It can respond to financial, social or safety needs or questions of dignity, as is the case with prisoners when they are transferred handcuffed and under custody to hospitals. Bringing health services closer to patients who cannot autonomously travel contributes towards humanising healthcare. Tele-consultations, long-distance encounters between patients and health professionals, reduce the direct and social costs inherent to habitual clinical practice and are very highly valued by patients in prison. Despite its potential benefits in the prison setting, the implementation of telemedicine in Spain continues to be scarce and irregular, which, amongst other things, is due to a lack of awareness of this healthcare practice, the severe shortage of resources currently endemic to the prison health service system and the lack of interoperability solutions for clinical information between the healthcare administration and the prison health services, which unfortunately continue to depend on an organisation outside the healthcare ambit (the Ministry of Home Affairs), despite the legal provisions requiring them to be fully integrated into regional health services. The SARA (Administration Applications and Networks Systems) Network and the Reúnete © Service offer solid, secure, free technology is available to all prisons, to set in motion telemedicine programs at a nationwide level.

Programa de certificación de Centros de Adicciones para la eliminación del virus de la hepatitis C en España. Proyecto HepCelentes

“…De esta forma, vincular el diagnóstico con el inicio precoz del tratamiento directamente en el centro de adicciones (Morales-Arráez et al, 2021) e instaurar programas de acompañamiento hospitalario o por pares facilitaría el acceso a los especialistas de los servicios de digestivo, hepatología o enfermedades infecciosas, reduciría el aislamiento del paciente y mejoraría la adherencia y persistencia al tratamiento (Litwin et al, 2019). La interacción entre profesionales sanitarios y la falta de acceso al especialista por los usuarios de los centros de adicciones también podría mejorar mediante la implantación de la telemedicina de forma habitual (Cuadrado et al, 2021;Mateo et al, 2019;Morales Arráez et al, 2021).…”

The Recent Progress and Applications of Digital Technologies in Healthcare: A Review

“…However, despite the definite advantages of the application of telemedicine in correctional facilities, only little progress has been done up-to-date. Mateo et al highlighted the problems that hinder the more widespread implementation of telemedicine in prisons: (1) the lack of information and official guidelines, (2) internet security risks and elevated costs, (3) shortage of resources in the prison health services (that can operate telemedicine system), and (4) the need to maintain two separate electronic clinical history systems, for the prison and regional health services [103].…”

La edad como factor determinante en la atención por teleconsulta

“…A pesar de las disposiciones legales que exigen en España, las cuales indican que la telemedicina sea plenamente integrada en los servicios regionales de salud y en el ámbito penitenciario, esta modalidad sigue siendo escasa e irregular, lo que, entre otras cosas, se debe al desconocimiento de esta práctica asistencial y a la grave escasez de recursos que actualmente es endémica en el sistema penitenciario. Por ello Mateo et al (2019) concluyen que el sistema sanitario y la falta de soluciones de interoperabilidad de la información clínica, entre la administración sanitaria y los servicios sanitarios penitenciarios, lamentablemente siguen dependiendo de una organización ajena como resulta ser el Ministerio del Interior, lo que afecta la práctica de teleconsulta 6 .…”