Corrections_Today_Summer_2025_Vol.87_No.2

TECHNOLOGY

The plan was to initiate a 60-day pilot with the goal of successfully completing at least 250 virtual sick call visits, which was the predetermined volume of visits necessary to significantly decrease internal correctional officer escorted transfers. After the scope of the service was finalized and a success metric determined, a swim lane diagram was developed to illustrate the clinical workflow. The justice involved patients at Hudson County submit sick call requests through a kiosk system, and after a face-to-face encounter with a registered nurse, the nurse completes a review process to triage the sick call requests to ensure patients are seen by the most appropriate provider in a timely manner. Using clinical criteria approved by the medical providers onsite at Hudson County, the nurse identifies patients eligible and appropriate for the virtual sick call clinic. Patients that do not meet criteria are scheduled for the “in person” sick call clinic. The nurse remotely conducts a medical review of the patient’s pertinent information and consults with a medical provider to confirm the patient is appropriate for a telehealth provider visit and to prepare the provider for the encounter. The nurse schedules the patient with the provider through the electronic medical record and the telehealth platform. The encounter scheduled through the telehealth platform creates a unique appointment link. The nurse sends a message to the patient via the tablet and provides information on the patient’s virtual sick call appointment, including the day, time and link to access the visit. On the day of the appointment, the patient receives another electronic notification on their tablet with a visit reminder. A medical assistant enters the housing unit to collect vital signs on the patient and enters that infor mation into the electronic medical record. At Hudson County, the patient conducts their visit alone in their cell to ensure privacy, but other privacy options are available for different environments. After clicking on the visit link, the patient can electronically consent to the process or choose to be scheduled into an “in person” clinic. After the patient en ters the virtual visit waiting room, the medical provider opens the encounter and begins the virtual visit. During the visit, the medical provider conducts their typical visit tasks, including inquiries about the patient’s condition and generates a treatment plan for the patient. The plan

is communicated to the patient and entered into the electronic medical record. The remote nurse then follows up with the medical provider to facilitate the treatment plan (e.g., orders, referrals, etc.). After the visit ends, the patient can take an optional survey to provide feedback on their experience. After a very successful first month of pilot activity, the Hudson County Director requested expansion of the scope of the pilot to also include mental health visits. Using a similar approach, two days of mental health clin ics were scheduled to demonstrate that the tablets’ use could be expanded to different clinical specialties. At the completion of the pilot, the initiative surpassed the established goal of 250 visits by suc cessfully conducting 383 virtual sick call encounters. In addition, a mental health professional was added to the project team and successfully conducted 26 mental health visits. In total, 409 virtual visits were success fully completed between both sick call and mental health services. Leveraging telehealth can decrease the volume of internal, correctional officer escorted transfers to the fixed clinic site, helping to ensure the provision of timely, efficient, clinically appropriate medical care, while simultaneously reducing safety risks.

Service expansion and outcomes After the 60-day pilot, the new service model has continued, enhancing overall care delivery. Since the in ception of the service, thousands of virtual encounters have been successfully conducted through the tablets into the housing units, including sick call visits, mental

Corrections Today | Summer 2025

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